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This study aimed to evaluate heavy metals concentrations in soils and vegetables (cabbage, lettuce, and cassava) cultivated at Matola and Beluluane Industrial Parks, and to assess health risks linked to their consumption through estimated daily intake, hazard index (HI), and incremental lifetime cancer risk. Concentrations of Al, As, Co, Cd, Cr, Ni, Pb, and Zn were determined in the two sites. Soil concentrations of As at Beluluane site and As, Cd, and Cr at Matola site exceeded reference limits of the Food and Agriculture Organization/World Health Organization, showing heavy metal contamination. At Beluluane site, all studied vegetables presented As and Pb levels higher than reference limits, Cd concentrations were higher than the reference limit in cabbage, lettuce, and cassava leaves. At Matola site crops concentrations of As, Cd, Cr, and Pb exceeded the reference limits. Zinc exceeded the reference limit in all crops except in cabbage. HIs for vegetables from Beluluane exceeded 1.0 in cabbage (2.66), lettuce (2.27), and cassava leaves (2.37). Likewise, at Matola, HIs exceeded 1.0 in lettuce (1.67), cassava leaves (1.65), and root tubers (13). We found that vegetables cultivated in industrial parks present high carcinogenic risk due to heavy metal contamination, rendering them unsuitable for human consumption.
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Contaminación de Alimentos , Metales Pesados , Contaminantes del Suelo , Metales Pesados/análisis , Humanos , Contaminantes del Suelo/análisis , Medición de Riesgo , Mozambique , Contaminación de Alimentos/análisis , Verduras/química , Productos Agrícolas/química , Monitoreo del AmbienteRESUMEN
The treatment of peri-implantitis is challenging in the clinical practice of implant dentistry. With limited therapeutic options and drug resistance, there is a need for alternative methods, such as photodynamic therapy (PDT), which is a minimally invasive procedure used to treat peri-implantitis. This study evaluated whether the type of photosensitizer used influences the results of inflammatory control, reduction in peri-implant pocket depth, bleeding during probing, and reduction in bone loss in the dental implant region. We registered the study in the PROSPERO (International Prospective Register of Systematic Review) database. We searched three main databases and gray literature in English without date restrictions. In vivo randomized clinical studies involving individuals with peri-implantitis, smokers, patients with diabetes, and healthy controls were included. PDT was used as the primary intervention. Comparators considered mechanical debridement with a reduction in pocket depth as the primary outcome and clinical attachment level, bleeding on probing, gingival index, plaque index, and microbiological analysis as secondary outcomes. After reviewing the eligibility criteria, we included seven articles out of 266. A great variety of photosensitizers were observed, and it was concluded that the selection of the most appropriate type of photosensitizer must consider the patient's characteristics and peri-implantitis conditions. The effectiveness of PDT, its effects on the oral microbiome, and the clinical patterns of peri-implantitis may vary depending on the photosensitizer chosen, which is a crucial factor in personalizing peri-implantitis treatment.
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BACKGROUND: In recent years, improvement of Health-Related Quality of Life (HRQoL) in Ulcerative colitis (UC) has become a relevant measure for treatment efficacy. METHODS: We report results from a multicenter prospective study in Italy investigating HRQoL in adult patients with UC treated with golimumab (GLM). Patients who had shown clinical response after a 6-week induction phase (w0), were followed for an additional 48 weeks (w48) (total 54-week treatment). RESULTS: Of the 159 patients enrolled 90 completed the study. Compared to values at the beginning of treatment (n = 137), significant improvements were observed for mean total Inflammatory Bowel Disease Questionnaire (IBDQ) scores at w0 (168.5) and w48 (181.7). Patients with baseline PMS above the median tended to have greater improvements in IBDQ at w0 (OR 2.037, p = 0.033) and w48 (OR 3.292, p = 0.027). Compared to beginning of GLM treatment, the mean Full Mayo Score (FMS) decreased by 5.9 points at w48, while mean Partial Mayo Score (PMS) decreased by 3.9 points at w0 and by 4.9 points at w48. CONCLUSIONS: GLM improved HRQoL, disease activity and inflammatory biomarkers in UC patients with moderate-to-severely active disease. The greater the burden of disease activity at baseline, the greater the improvement of HRQoL after 24 and 48 weeks of treatment.
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Colitis Ulcerosa , Enfermedades Inflamatorias del Intestino , Adulto , Humanos , Colitis Ulcerosa/tratamiento farmacológico , Calidad de Vida , Estudios Prospectivos , Anticuerpos Monoclonales/uso terapéutico , Resultado del Tratamiento , Enfermedades Inflamatorias del Intestino/tratamiento farmacológico , Índice de Severidad de la EnfermedadRESUMEN
PURPOSE: To investigate the effects of two ultrasonic vibration protocols for cast post removal (single or double ultrasound units) on the development of defects in root dentin. METHODS: Sixty bovine incisors were selected. Fifteen roots were left unprepared (control). Forty-five roots were instrumented and filled. A 10-mm post space was prepared using #1-4 Largo drills. Fifteen teeth were prepared for post space and received no further procedure. Thirty roots had cast posts cemented and were submitted to ultrasonic vibration protocols for removal. The time necessary to remove each post was recorded. Roots were sectioned 3, 6, 9, and 12 mm from the coronal portion and viewed through a 25× magnification in a stereomicroscope. The presence of root fractures, partial cracks, and craze lines was registered. Chi-square and Fisher's exact tests were performed to compare the incidence of dentin defects. The Kruskal-Wallis test was performed to explore the difference between the time needed for post removal. The significance level was set at P = 0.05. RESULTS: Root defects were observed in all experimental groups. There were no statistical differences comparing previous root canal treatment and post removal steps, either with 1 or 2 ultrasonic units, in the formation of defects (P = 0.544) or fractures (P = 0.679). CONCLUSION: Ultrasonic vibration protocols for removing cast posts did not increase the number of dentin defects compared to root canal preparation and obturation and post space preparation steps.
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Técnica de Perno Muñón , Fracturas de los Dientes , Animales , Bovinos , Incidencia , Fracturas de los Dientes/prevención & control , Fracturas de los Dientes/etiología , Raíz del Diente , Preparación del Conducto Radicular/métodos , Dentina , Ondas Ultrasónicas , Técnica de Perno Muñón/efectos adversos , Cavidad Pulpar , Vibración/uso terapéuticoRESUMEN
PURPOSE: To evaluate the effect of intra-radicular cleaning protocols after post-space preparation (PSP) on marginal adaptation of a luting agent to root dentin. METHODS: Eighty bovine incisors were sectioned transversely to obtain 18-mm-long root sections. The roots were prepared with ProTaper instruments and filled using Tagger's hybrid technique. PSP was performed at a length of 14 mm using #3-5 Largo drills. The roots were distributed into eight groups according to the chelating solution used (17% EDTA or 0.2% Chitosan) and the chelating activation/delivery method employed (conventional needle irrigation [CNI], EndoActivator [EA], XP-Endo Finisher [XPF] or passive ultrasonic irrigation [PUI]). The fiber posts were cemented using self-adhesive resin cement, and the roots were sectioned to obtain three discs from each root third. The dentin discs were observed under an optical microscope at ×40 magnification to assess marginal adaptation. The different protocols were compared considering the frequency of the marginal adaptation scores using the Kruskal-Wallis test, followed by the Dwass-Steel-Critchlow-Fligner test (α = 5%). RESULTS: The use of 17% EDTA resulted in better marginal adaptation (P < 0.001). PUI yielded results that were similar to those for EA (P = 0.949) and superior to those for XPF (P = 0.020). The combination of 17% EDTA + PUI provided a greater number of interfaces without marginal gaps (P < 0.001). CONCLUSION: The cleaning protocol influenced the marginal adaptation of resin cement to root dentin.
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Cementos Dentales , Técnica de Perno Muñón , Animales , Bovinos , Cementos Dentales/farmacología , Cementos de Resina , Ácido Edético/farmacología , Microscopía Electrónica de Rastreo , Dentina , Preparación del Conducto Radicular/métodos , Cavidad Pulpar , Irrigantes del Conducto Radicular/farmacologíaRESUMEN
RESUMEN Los aneurismas de la arteria hepática son una patología poco frecuente. Cuando son sintomáticos, se debe sospechar un sufrimiento aneurismático y su tratamiento está indicado. Presentamos el caso clínico de un paciente con mal terreno cardiovascular, que consultó por un cuadro clínico de dolor epigástrico, repercusión hemodinámica e ictericia. La imagenología evidenció la presencia de un aneurisma de la arteria hepática común complicado con compromiso del origen de la arteria hepática propia y la arteria gastroduodenal. La presencia de una vascularización arterial hepática "no convencional" con una arteria hepática derecha proveniente de la arteria mesentérica superior, en la angiotomografía, permitió cambiar la táctica quirúrgica haciéndose prescindible la realización de un bypass. Este caso resalta la importancia de determinar en el preoperatorio no solo la extensión del aneurisma, sino también la anatomía vascular hepática a fin de planificar mejor la cirugía, disminuyendo así la morbimortalidad de esta enfermedad.
ABSTRACT Hepatic artery aneurysms are rare. Expanding aneurysms should be suspected in case of symptoms and treatment is indicated. We report the case of a patient with a history of cardiovascular disease who sought medical care due to epigastric pain, hemodynamic instability and jaundice. The imaging tests showed the presence of an aneurysm of the common hepatic artery complicated with involvement of the origin of the proper hepatic artery and the gastroduodenal artery. The surgical approach could be changed due to presence of a "non-conventional" hepatic arterial variant with a right hepatic artery originating from the superior mesenteric artery in the computed tomography angiography as bypass surgery was not necessary. This case highlights the importance of determining the extent of the aneurysm in the preoperative period and the anatomy of the hepatic vessels to better plan the surgery, thus reducing morbidity and mortality of this disease.
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Humanos , Masculino , Anciano , Aneurisma Roto/cirugía , Arteria Hepática/patología , Aneurisma Roto/diagnóstico por imagen , Hemoperitoneo/diagnóstico por imagen , Arteria Hepática/cirugía , LaparotomíaRESUMEN
INTRODUCTION: The aim of this study was to determine the frequency and risk factors of maxillary sinusitis of endodontic origin (MSEO) on posterior maxillary teeth evaluated using dynamic navigation and a novel filter of cone-beam computed tomographic (CBCT) imaging. METHODS: CBCT scans of 453 patients (814 teeth) were selected. Data were divided into 4 groups: (1) root canal treatment (RCT), (2) relation of the root apex to the maxillary sinus, (3) apical periodontitis (AP), and (4) maxillary sinus inflammation (no inflammation, periapical osteoperiostitis, periapical mucositis, partial obstruction, or total obstruction). Frequency distribution and cross-tabulation were used for data analysis. The association of maxillary sinus abnormalities with other variables was analyzed using the chi-square test. The significance level was set at 5%, and the association between dependent and independent variables was analyzed using robust Poisson regression models. RESULTS: MSEO was found in 65.6% of the cases, and the highest frequency rates were in the periapical mucositis (44%) and partial obstruction (15.8%) groups. The rates of risk factors were highest in the cases of RCT (54.9%), AP (34.3%), and the root apex in contact with the maxillary sinus (53.8%). The most frequent sex and age group were female (55.8%) and 41-50 years (30.5%). CONCLUSIONS: The frequency of MSEO was high and positively associated with RCT, AP, and the root apex's position in contact with the floor of the maxillary sinus. The maxillary sinus filter of the CBCT software provides a clear image of maxillary sinus abnormalities.
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Sinusitis Maxilar , Mucositis , Periodontitis Periapical , Tomografía Computarizada de Haz Cónico/métodos , Femenino , Humanos , Masculino , Seno Maxilar , Sinusitis Maxilar/diagnóstico por imagen , Sinusitis Maxilar/etiología , Mucositis/complicaciones , Periodontitis Periapical/complicaciones , Periodontitis Periapical/etiología , Factores de RiesgoRESUMEN
The pathogenesis of the severity of chikungunya infection is not yet fully understood. OBJECTIVE: To assess the role of the cytokines/chemokines and system of complement in the evolution of chikungunya infection. METHODS: In both acute and chronic phases, we measured the serum levels of 12 cytokines/chemokines and two complement mediators: mannose-binding lectin (MBL) and C3a, in 83 patients with chikungunya infection and ten healthy controls. RESULTS: During the acute phase, 75.9% of the patients developed musculoskeletal disorders, and in 37.7% of them, these disorders persisted until the chronic phase. In general, patients had higher levels of cytokines than healthy controls, with significant differences for IFN-γ, IL-6, IL-8, IL-10, and MIP-1. Most cytokines exhibited a downward trend during the chronic phase. However, only IL-10, and MIP-1 levels were significantly lower in the chronic phase. Additionally, these levels never decreased to concentrations found in healthy controls. Moreover, MBL levels were significantly higher in the acute phase compared with the chronic phase. C3a levels were significantly higher in patients with musculoskeletal disorder compared with patients without it, in both acute-phase 118.2 (66.5-252.9), and chronic phase 68.5 (64.4-71.3), P < 0.001. Interestingly, C3a levels were significantly higher when patients had a severe disease version. Besides, in the acute phase, C3a levels were higher in patients that suffer arthritis as opposed to when they suffer arthralgia, 194.3 (69.5-282.2), and 70.9 (62.4-198.8), P = 0.013, respectively. CONCLUSIONS: Our results showed an immunological response that persisted until the chronic phase and the role of the complement system in the severity of the disease.
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A new species of Sarcophagidae (Diptera) in the genus Helicobia Coquillett, Helicobia neuzalmeidae sp. nov., is described based on two male specimens obtained from pig carcasses in savanna-like vegetation in northeastern Brazil (state of Maranhão) during a forensic study. The holotype was obtained from a larva that abandoned the pig carcass to pupate, whereas the paratype was collected with a trap placed above the cage containing the carcass. This is the first record of a Helicobia species reared from a vertebrate carcass.
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Dípteros , Sarcofágidos , Enfermedades de los Porcinos , Animales , Brasil , Cadáver , Pradera , Masculino , PorcinosRESUMEN
Neutrophils are innate immune cells that play an essential role during the clearance of pathogens that can release chromatin structures coated by several cytoplasmatic and granular antibacterial proteins, called neutrophil extracellular traps (NETs). These supra-molecular structures are produced to kill or immobilize several types of microorganisms, including bacteria and viruses. The contribution of the NET release process (or NETosis) to acute inflammation or the prevention of pathogen spreading depends on the specific microorganism involved in triggering this response. Furthermore, studies highlight the role of innate cells different from neutrophils in triggering the release of extracellular traps during bacterial infection. This review summarizes the contribution of NETs during bacterial and viral infections, explaining the molecular mechanisms involved in their formation and the relationship with different components of such pathogens.
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The induction of trained immunity represents an emerging concept defined as the ability of innate immune cells to acquire a memory phenotype, which is a typical hallmark of the adaptive response. Key points modulated during the establishment of trained immunity include epigenetic, metabolic and functional changes in different innate-immune and non-immune cells. Regarding to epigenetic changes, it has been described that long non-coding RNAs (LncRNAs) act as molecular scaffolds to allow the assembly of chromatin-remodeling complexes that catalyze epigenetic changes on chromatin. On the other hand, relevant metabolic changes that occur during this process include increased glycolytic rate and the accumulation of metabolites from the tricarboxylic acid (TCA) cycle, which subsequently regulate the activity of histone-modifying enzymes that ultimately drive epigenetic changes. Functional consequences of established trained immunity include enhanced cytokine production, increased antigen presentation and augmented antimicrobial responses. In this article, we will discuss the current knowledge regarding the ability of different cell subsets to acquire a trained immune phenotype and the molecular mechanisms involved in triggering such a response. This knowledge will be helpful for the development of broad-spectrum therapies against infectious diseases based on the modulation of epigenetic and metabolic cues regulating the development of trained immunity.
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Interacciones Huésped-Patógeno/inmunología , Inmunidad Celular , Inmunidad Innata/inmunología , Memoria Inmunológica/inmunología , Inmunidad Adaptativa/genética , Inmunidad Adaptativa/inmunología , Inmunidad Adaptativa/fisiología , Animales , Vacuna BCG/inmunología , Bronquios/citología , Bronquios/inmunología , Citocinas/fisiología , Metabolismo Energético , Epigénesis Genética , Células Epiteliales/inmunología , Tracto Gastrointestinal/citología , Tracto Gastrointestinal/inmunología , Células Madre Hematopoyéticas/inmunología , Interacciones Huésped-Patógeno/genética , Interacciones Huésped-Patógeno/fisiología , Humanos , Inmunidad Celular/genética , Inmunidad Celular/fisiología , Inmunidad Innata/genética , Inmunidad Innata/fisiología , Memoria Inmunológica/genética , Memoria Inmunológica/fisiología , Linfocitos/inmunología , Ratones , Células Mieloides/inmunología , NAD/fisiología , Piel/citología , Piel/inmunologíaRESUMEN
BACKGROUND: Identifying risk factors for Triatominae infestation is essential for the development of vector control interventions. METHODS: To determine the intra- and peridomiciliary risk factors associated with triatomine infestation, a cross-sectional analytical study was carried out with random cluster sampling in two stages, which included the identification of risk factors by survey and direct observation, as well as the search and capture of triatomines. The detection of trypanosomes in triatomines was carried out by observing the rectal content and then by conventional polymerase chain reaction (PCR). RESULTS: In 21 of the 207 houses inspected, 13 specimens of R. colombiensis and 19 specimens of P. geniculatus were found. Entomological indices included: dispersion 36%, infestation 10%, infection 65%, colonization 4.7%, density 15%, and concentration 152%. An association was found between the presence of Triatominae and the existence of branches and fissures in the floors, as well as with the presence of accumulated objects and with knowledge about Chagas disease. The risk of having triatomines in urban homes is 5.7 times higher than the risk in rural areas [confidence interval (CI) 0.508-67.567]; 6.6 times in houses with cracked soil (CI 0.555-81.994), 6 times in houses located near caneys (CI 0.820-44.781), and 6.16 times with accumulated objects (CI 1.542-39.238). CONCLUSION: Chagas disease is a complex problem that requires control based on the vector's elimination or surveillance, which implies identifying species and their distribution, generating alerts, knowledge, and awareness in the population. It is necessary to intensify surveillance activities for the event, especially in changing aspects of Chagas diseases' transmission dynamics, such as urbanization and the type of housing associated with the vector's presence.
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INTRODUCTION: The effectiveness of bowel cleansing is a key element for high-quality colonoscopy. Recently, a 1â¯L polyethylene glycol plus ascorbate (PEG-ASC) solution has been introduced, but effectiveness and safety of this preparation have not been assessed in IBD patients. This study aims to evaluate effectiveness and safety of 1â¯L PEG-ASC solution in patients with IBD compared to controls. METHODS: We retrospectively analysed prospectively collected data on a cohort of 411 patients performing a colonoscopy after preparation with 1â¯L PEG-ASC, consecutively enrolled in 5 Italian centres. RESULTS: Overall, 185/411 (45%) were patients with IBD and 226/411 (55%) served as controls. A significantly higher cleansing success was achieved in IBD patients (92.9% vs 85.4%, pâ¯=â¯0.02). The multiple regression model showed that presence of IBD (OR=2.514, 95%CI=1.165-5.426; Pâ¯=â¯0.019), lower age (OR=0.981, 95%CI=0.967-0.996; Pâ¯=â¯0.014), split preparation (OR=2.430, 95%CI=1.076-5.492; Pâ¯=â¯0.033), absence of diabetes (OR=2.848, 95%CI=1.228-6.605; Pâ¯=â¯0.015), and of chronic constipation (OR=3.350, 95%CI=1.429-7.852; Pâ¯=â¯0.005), were independently associated with cleansing success. The number of treatment-emergent adverse events (TEAEs) (51â¯vs 62%, pâ¯=â¯0.821), and of patients with TEAEs (22.2% vs 21.2%, pâ¯=â¯0.821), were similar in IBD patients and in controls, respectively. CONCLUSIONS: Results from this study support the effectiveness and safety of 1â¯L PEG-ASC solution in IBD patients, which may improve the definition of endoscopic outcomes both in Crohn's disease and ulcerative colitis.
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Ácido Ascórbico/análogos & derivados , Catárticos/administración & dosificación , Colitis Ulcerosa/complicaciones , Colonoscopía/métodos , Enfermedad de Crohn/complicaciones , Fosfatidiletanolaminas/administración & dosificación , Adulto , Ácido Ascórbico/administración & dosificación , Ácido Ascórbico/efectos adversos , Catárticos/efectos adversos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Fosfatidiletanolaminas/efectos adversos , Estudios RetrospectivosRESUMEN
Dengue and Zika are two mosquito-borne diseases of great impact on public health around the world in tropical and subtropical countries. DENV and ZIKV belong to the Flaviviridae family and the Flavivirus genus. Currently, there are no effective therapeutic agents to treat or prevent these pathologies. The main objective of this work was to evaluate potential inhibitors from active compounds obtained from Marcetia taxifolia by performing inverse molecular docking on ZIKV-NS3-helicase and ZIKV-NS5-RNA polymerase as targets. This computational strategy is based on renormalizing the binding scores of the compounds to these two proteins, allowing a direct comparison of the results across the proteins. The crystallographic structures of the ZIKV-NS3-helicase and ZIKV-NS5-RNA-polymerase proteins share a great similarity with DENV homologous proteins. The P-loop active site of the crystallographic structure of ZIKV-NS3-helicase presents a high percentage of homology with the four dengue serotypes. It was found that most ligands of the active compounds (5,3'-dihydroxy-3,6,7,8,4'-pentamethoxyflavone (5DP); 5-hydroxy-3,6,7,8,3',4'-hexamethoxyflavone (5HH); myricetin-3-O-rhamnoside (M3OR)) from Marcetia taxifolia had a better affinity for ZIKV-NS3-helicase than for ZIKV-NS5-RNA polymerase, as indicated by the negative multiple active site correction (MASC) score, except for M3RG that showed a higher affinity for ZIKV-NS5-RNA polymerase. On the other hand, the AutoDock Vina scores showed that M3OR had the highest score value (-9.60 kcal/mol) and the highest normalized score (1.13) against ZIKV-NS3-helicase. These results in silico demonstrated that the nonstructural proteins NS3-helicase and NS5-RNA polymerase, which share similar molecular structures between the selected viruses, could become therapeutic targets for some bioactive compounds derived from Marcetia taxifolia.
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Prenatal glucocorticoid overexposure has been shown to programme adult cardiovascular function in a range of species, but much less is known about the long-term effects of neonatal glucocorticoid overexposure. In horses, prenatal maturation of the hypothalamus-pituitary-adrenal axis and the normal prepartum surge in fetal cortisol occur late in gestation compared to other precocious species. Cortisol levels continue to rise in the hours after birth of full-term foals and increase further in the subsequent days in premature, dysmature and maladapted foals. Thus, this study examined the adult cardiovascular consequences of neonatal cortisol overexposure induced by adrenocorticotropic hormone administration to full-term male and female pony foals. After catheterisation at 2-3 years of age, basal arterial blood pressures (BP) and heart rate were measured together with the responses to phenylephrine (PE) and sodium nitroprusside (SNP). These data were used to assess cardiac baroreflex sensitivity. Neonatal cortisol overexposure reduced both the pressor and bradycardic responses to PE in the young adult males, but not females. It also enhanced the initial hypotensive response to SNP, slowed recovery of BP after infusion and reduced the gain of the cardiac baroreflex in the females, but not males. Basal diastolic pressure and cardiac baroreflex sensitivity also differed with sex, irrespective of neonatal treatment. The results show that there is a window of susceptibility for glucocorticoid programming during the immediate neonatal period that alters cardiovascular function in young adult horses in a sex-linked manner.
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Sistema Cardiovascular/patología , Nitroprusiato/toxicidad , Fenilefrina/toxicidad , Animales , Animales Recién Nacidos , Sistema Cardiovascular/efectos de los fármacos , Femenino , Caballos , Masculino , Factores Sexuales , Vasoconstrictores/toxicidad , Vasodilatadores/toxicidadRESUMEN
OBJECTIVE: The recurrence of Crohn's Disease after ileo-colonic resection is a crucial issue. Severe endoscopic lesions increase the risk of developing early symptoms. Prevention and treatment of post-operative Endoscopic Recurrence (ER) have been studied with conflicting results. We compare effi cacy of azathioprine (AZA) vs. high-dose 5-aminosalicylic acid (5-ASA) in preventing clinical recurrence and treating severe post-operative ER. PATIENTS AND METHODS: We performed a 1-year multicenter randomized double-blind double-dummy trial. Primary end-points were endoscopic improvement and therapeutic failure (clinical recurrence or drug discontinuation due to lack of efficacy or adverse events) 12 months after randomization. We also performed a post-trial analysis on symptomatic and endoscopic outcomes 10 years after the beginning of the trial, with a median follow-up of 60 months. RESULTS: Therapeutic failure occurred in 8 patients (17.4%) within 12 months from randomization, with no significant difference between patients treated with 5-ASA (20.8%, 5 patients) and those with AZA (13.6%, 3 patients). Therapeutic failure was due to clinical recurrence in the 5-ASA group and to adverse events in the AZA group. Endoscopic improvement at 12 months was observed in 8 patients, 2 (11.8%) in the 5-ASA group and 6 (30%) in the AZA group. No serious adverse event was recorded. At the post-trial analysis (median follow-up 60 months), 47.8% (22/46) of patients experienced clinical recurrence: 54.2% (13/24) in the 5-ASA group and 40.9% (9/22) in the AZA group, p=0.546. Patients treated with AZA had lower risk of drug escalation. Clinical recurrence was associated with smoking (p=0.031) and previous surgery (p=0.003). CONCLUSIONS: Our trial indicates that there was no difference in terms of treatment failure between 5-ASA and AZA in patients with severe ER. The main limit of AZA is its less favorable safety profile.
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Azatioprina/efectos adversos , Enfermedad de Crohn/tratamiento farmacológico , Mesalamina/efectos adversos , Enfermedad de Crohn/patología , Método Doble Ciego , Humanos , RecurrenciaRESUMEN
Motschulsky (1859), a Russian Imperial Army Colonel and entomologist, established the genus Exopholis, described E. birmannica and transferred Melolontha hypoleuca Wiedemann, 1819 to it. Brenske (1896) described Exopholis philippinica from the "Philippinen" from a single female specimen. Dalla Torre (1912), listed eight species under the genus Exopholis Motschulsky, 1859 from South East Asia: E. hypoleuca (Weidemann, 1819) (Myanmar, Malaysia, Borneo, Java, Sumatra, Nias, Ambon), E. costata (Burmeister, 1855) (Java, Nias), E. birmanica Motschulsky, 1859 (Myanmar), E. lacordairei Waterhouse, 1867 (Borneo), E. pinguis Lansberge, 1879 (Sumatra), E. brenskei Nonfried, 1891, E. borneensis Brenske, 1894 (both from Borneo) and E. philippinica Brenske, 1896 (Philippines). This paper aims to review the taxonomy of Exopholis from the Philippines. Specifically, to focus on the diagnosis of Exopholis philippinica and its geographic distribution.
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Escarabajos , Animales , Femenino , FilipinasRESUMEN
BACKGROUND: Electrochemotherapy (ECT) is a treatment for both primary and secondary cutaneous tumours. The international Network for sharing practices on ECT group investigates treatment outcomes after ECT using a common database with defined parameters. METHODS: Twenty-eight centres across Europe prospectively uploaded data over an 11-year period. Response rates were investigated in relation to primary diagnosis, tumour size, choice of electrode type, route of bleomycin administration, electrical parameters recorded and previous irradiation in the treated field. RESULTS: Nine hundred eighty-seven patients, with 2482 tumour lesions were included in analysis. The overall response (OR) rate was 85% (complete response [CR]: 70%, partial response rate: 15%, stable disease: 11%, and progressive disease: 2%). For different histologies, OR and CR rates for metastases of malignant melanoma were 82% and 64%, basal cell carcinoma were 96% and 85%, breast cancer metastases were 77% and 62%, squamous cell carcinoma were 80% and 63% as well as Kaposi's sarcoma were 98% and 91%, respectively. Variance was demonstrated across histotypes (p < 0.0001) and in accordance with size of lesion treated (dichotomised at diameter of 3 cm (p < 0.0001). Hexagonal electrodes were generally used for larger tumours, but for tumours up to 3 cm, linear array electrodes provided better tumour control than hexagonal electrodes (80%:74%, p < 0.003). For tumours more than 2 cm, intravenous administration was superior to intratumoural (IT) administration (p < 0.05). Current recorded varied across tumour histologies and size but did not influence response rate. In previously irradiated areas, responses were selectively lower for IT administration. CONCLUSIONS: These cumulative data endorse efficiency of ECT across a broad range of histotypes. Analysis of 2482 lesions details subgroup analysis on treatment response informing future treatment choices.
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Electroquimioterapia/métodos , Neoplasias Cutáneas/terapia , Adulto , Anciano , Anciano de 80 o más Años , Bases de Datos Factuales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Neoplasias Cutáneas/patología , Adulto JovenRESUMEN
Cellulose nanocrystals (CNC) and xyloglucan (XG) were used to construct new aerogels inspired by the hierarchical organization of wood tissue, i.e., anisotropic porous cellular solid with pore walls containing oriented and stiff cellulose nanorods embedded in hemicellulose matrix. Aerogels with oriented or disordered pores were prepared by directional and non-directional freeze-casting from colloidal dispersions of XG and CNC at different ratios. XG addition induced a clear improvement of the mechanical properties compared to the CNC aerogel, as indicated by the Young modulus increase from 138 kPa to 610 kPa. The addition of XG changed the pore morphology from lamellar to alveolar and it also decreased the CNC orientation (the Hermans' orientation factor was 0.52 for CNC vs 0.36-0.40 for CNC-XG). The aerogels that contained the highest proportion of XG also retained their structural integrity in water without any chemical modification. These results open the route to biobased water-resistant materials by an easy and green strategy based on polymer adsorption rather than chemical crosslinking.
Asunto(s)
Pared Celular/química , Celulosa/química , Geles/química , Glucanos/química , Nanopartículas/química , Plantas/química , Agua/metabolismo , Xilanos/química , Adsorción , CongelaciónRESUMEN
AIM: The SphinKeeper™ artificial bowel sphincter implant is a relatively new surgical technique for the treatment of refractory faecal incontinence. This study presents the first experience in two UK tertiary centres. METHOD: This is a retrospective audit of prospectively collected clinical data in relation to technique, safety, feasibility and short-term effectiveness from patients undergoing surgery from January 2016 to April 2019. Baseline data, intra-operative and postoperative complications, symptoms [using St Mark's incontinence score (SMIS)] and radiological outcomes were analysed. RESULTS: Twenty-seven patients [18 women, median age 57 years (range 27-87)] underwent SphinKeeper. In 30% of the patients, the firing device jammed and not all prostheses were delivered. There were no intra-operative complications and all patients were discharged the same or the following day. SMIS significantly improved from baseline [median -6 points (range -12 to +3); P < 0.00016] with 14/27 (51.9%) patients achieving a 50% reduction in the SMIS score. On postoperative imaging, a median of seven prostheses (range 0-10) were identified with a median of five (range 0-10) optimally placed. There was no relationship between number of well-sited prostheses on postoperative imaging and categorical success based on 50% reduction in SMIS (χ2 test, P = 0.79). CONCLUSION: SphinKeeper appears to be a safe procedure for faecal incontinence. Overall, about 50% patients achieved a meaningful improvement in symptoms. However, clinical benefit was unrelated to the rate of misplaced/migrated implants. This has implications for confidence in proof of mechanism and also the need for technical refinement.