RESUMEN
Spontaneous intracerebral hemorrhage (ICH) represents a critical and potentially devastating medical event resulting from the rupture of intracerebral vessels. Patients afflicted with ICH face an increased risk of venous thromboembolism (VTE) due to factors such as immobility. However, determining the ideal timing for initiating venous thromboembolism thromboprophylaxis (TP) remains uncertain, as it may carry the potential risk of exacerbating hematoma expansion. Thus, our objective was to ascertain the optimal timing for initiating TP following ICH through a comprehensive systematic review and meta-analysis.This systematic review and meta-analysis were performed following the Cochrane Collaboration and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement guidelines, considering outcomes based on the time of intervention: Ultra early (UEPT) < 24 h, Early (EPT) < 48 h, Late (LPT) > 48 h to perform an analysis on hematoma expansion and mortality.Of 2.777 Hematoma expansion was not more frequent in the 440 patients receiving UEPT/EPT (n = 440) versus 565 receiving LPT (Odds ratio (OR) 0.94 (95% CI; 0.62 to 1.43; I2 = 0%)). Similarly, mortality was not lower in the 293 received UEPT or EPT versus 477 receiving LPT (OR 0.63 (95% CI; 0.39 to 1.0; I2 = 0%).This study, through a systematic review and meta-analysis, conclusively found no difference in intracranial hematoma expansion and/or increased mortality between the use of heparin in the early thromboprophylaxis (< 48 h) group compared to the late thromboprophylaxis (> 48 h) group. Implementing this approach in the management of spontaneous cerebral hemorrhage could facilitate progress towards more optimal care protocols.
Asunto(s)
Hemorragia Cerebral , Tromboembolia Venosa , Humanos , Hemorragia Cerebral/complicaciones , Tromboembolia Venosa/prevención & control , Anticoagulantes/uso terapéutico , Factores de TiempoRESUMEN
Cavernous angioma is a sinusoidal dilatation covered by a single layer of endothelium, separated by a collagen matrix with elastin and smooth muscle.1 The prevalence in the general population is estimated at 0.4% to 0.9%,2 representing around 5% to 10% of all vascular malformations.3 Studies indicate 9% to 35% of cavernomas are found in deep locations such as the brainstem, thalamus, and basal ganglia.4-6 Common symptoms of these deep lesions are cranial nerve deficit, hemiparesis, and paresthesia. These lesions have high rates of rebleeding after the first episode of bleeding but present excellent results of surgical resection and modified Rankin in the long term.7-13 Internal capsule cavernomas are particularly challenging due to the important projection fibers surround them. Although the gold standard of treatment is microsurgery, there needs to be a consensus on the best approach for lesions of this topography. We present a video case of a female in her 50s with right hemiparesis and dysphasia, exhibiting grade 3/5 strength on the right side. T1 MRI revealed a high intensity, heterogeneous, multinodular signal in the left basal ganglia, with tractography showing the lesion dividing the posterior limb of the internal capsule amid fibers of the right corticospinal tract. The patient consented to the procedure and to the publication of his/her image. This study was approved by the Ethics and Research Committee of our institution. We demonstrated that the superior frontal sulcus is a safe corridor to surgically cure cavernomas of the internal capsule, with the recovery of previous deficits.
RESUMEN
BACKGROUND AND OBJECTIVE: Arteriovenous malformations (AVMs) are congenital lesions, and because of their structure, complexity, flow, size, and location organization, they are lesions that require extensive anatomic knowledge and mastery of microsurgical skills and techniques. Human placentas as a training model for AVM surgery are promising alternatives. This article aims to describe the technique for forming an AVM-type lesion in human placentas and its usefulness in the training of microsurgical treatment techniques. METHODS: In this study, 15 fresh human placental models were treated. A nidus was created using synthetic material, and dynamic flow was evaluated with intravascular injection of Indocyanine Green. The catheter system was connected to a continuous flow infusion pump. For simulation purposes, 4 vascular neurosurgeons and 4 vascular neurosurgery fellows used the same techniques and instruments used in real surgery to simulate the resection of AVM lesions. Subjective assessments were conducted, evaluating the validity and structured content on a 5-point Likert scale. Evaluation criteria included the execution of technical maneuvers and the model's expression and structural aspects. RESULTS: We describe the step-by-step creation of an AVM in a placental biological model for the performance of vascular microsurgery training in the laboratory. We created in the human placenta a lesion with the characteristics of an AVM for microsurgical training in the laboratory, which presents key features realistic to a real AVM, such as 1 or more feeder arteries, nidus (synthetic), draining vein(s), continuous and pulsatile flow, and 3-dimensional configuration. Furthermore, it demonstrates the applicability of microsurgical techniques to the model compared with performing surgery on a patient. CONCLUSION: Considering it an effective method for laboratory training, the creation of arteriovenous malformations in human placentas enables students to replicate, comprehend the structure, and master microsurgical techniques in a realistic model.
RESUMEN
Introduction: Deep cavernomas of eloquent areas, located in the region of the basal nuclei and thalamus, account for 9 to 36% of these encephalic vascular malformations. Internal capsule cavernomas are particularly challenging, as they are surrounded by important projection fibers and their manipulation can lead to permanent deficits. To demonstrate through surgical cases that cavernomas of the internal capsule can be approached by frontal craniotomy, via the superior frontal sulcus, in a curative manner and with low morbidity. Methods: We presented two cases of cavernomas of the internal capsule operated, whose treatment was microsurgical resection via frontal craniotomy and access to the lesion via the superior frontal sulcus, described step-by-step. To elucidate the rationale behind the decision, we used preoperative images with an emphasis on the patients' tractography and the importance of comparing these images with anatomical specimens dissected in the neuroanatomy and microsurgery laboratory. Results: The two cases of internal capsule cavernomas, one in the anterior limb and the other in the posterior limb, were treated surgically via the superior frontal sulcus. Discussion: Both patients showed radiological cure and clinical improvement in the post-operative segment. The patient consented to the procedure and to the publication of his/her image. Treatment of internal capsule cavernomas via the superior frontal sulcus has proven to be a safe and effective option.
RESUMEN
A group of Gram-negative plant-associated diazotrophic bacteria belonging to the genus Nitrospirillum was investigated, including both previously characterized and newly isolated strains from diverse regions and biomes, predominantly in Brazil. Phylogenetic analysis of 16S rRNA and recA genes revealed the formation of a distinct clade consisting of thirteen strains, separate from the formally recognized species N. amazonense (the closest species) and N. iridis. Comprehensive taxonomic analyses using the whole genomes of four strains (BR 11140T = AM 18T = Y-2T = DSM 2788T = ATCC 35120T, BR 11142T = AM 14T = Y-1T = DSM 2787T = ATCC 35119T, BR 11145 = CBAmC, and BR 12005) supported the division of these strains into two species: N. amazonense (BR 11142 T and BR 12005) and a newly proposed species (BR 11140 T and BR 11145), distinct from N. iridis. The phylogenomic analysis further confirmed the presence of the new Nitrospirillum species. Additionally, MALDI-TOF MS analysis of whole-cell mass spectra provided further evidence for the differentiation of the proposed Nitrospirillum species, separate from N. amazonense. Analysis of chemotaxonomy markers (i.e., genes involved in fatty acid synthesis, metabolism and elongation, phospholipid synthesis, and quinone synthesis) revealed that the new species highlights high similarity and evolutionary convergence with other Nitrospirillum species. This new species exhibited nitrogen fixation ability in vitro, it has similar NifHDK protein phylogeny position with the closest species, lacked denitrification capability, but possessed the nosZ gene, enabling N2O reduction, distinguishing it from the closest species. Despite being isolated from diverse geographic regions, soil types, and ecological niches, no significant phenotypic or physiological differences were observed between the proposed new species and N. amazonense. Based on these findings, a new species, Nitrospirillum viridazoti sp. nov., was classified, with the strain BR 11140T (DSM 2788T, ATCC 35120T) designated as the type strain.
Asunto(s)
Nitrógeno , Poaceae , Filogenia , ARN Ribosómico 16S/genética , Espectrometría de Masa por Láser de Matriz Asistida de Ionización DesorciónRESUMEN
OBJECTIVE: To evaluate the effect of fluoride consistency and composition to protect enamel and dentin against the dental erosion. MATERIALS AND METHODS: Bovine enamel and dentin specimens were treated with artificial saliva, neutral fluoride gel (NFG), acidulated phosphate fluoride gel (AFG), neutral fluoride foam (NFF), and acidulated phosphate fluoride foam. The samples were subjected to cycling. Micro energy-dispersive X-ray fluorescence spectrometry, surface roughness (Ra), contact angle (CA), and scanning electron microscopy (SEM) were performed. Composition, CA and Ra data were analyzed by ANOVA and multiple comparison test (p < 0.05). RESULTS: The dentin protected had a significantly higher mineral content than in the control. Eroded unprotected enamel had higher Ra values than normal surfaces. Fluoride treatments increased the Ra in dentin samples. AFG increased the CA in enamel. Fluoride foams increased CA in dentin with reduced mineral loss. SEM analysis found a deposited layer on enamel treated with AFG and remnants of deposits on dentin treated with NFG and NFF. CONCLUSION: Regardless of the form of application, fluoride provided protection against erosion, however with different levels. CLINICAL SIGNIFICANCE: Applying the adequate fluoride form is relevant since the formulations have different effects on both enamel and dentin.
Asunto(s)
Esmalte Dental , Dentina , Fluoruros , Microscopía Electrónica de Rastreo , Espectrometría por Rayos X , Propiedades de Superficie , Erosión de los Dientes , Animales , Erosión de los Dientes/prevención & control , Bovinos , Esmalte Dental/efectos de los fármacos , Dentina/efectos de los fármacos , Fluoruros/farmacología , Fluoruro de Fosfato Acidulado/farmacología , Saliva Artificial , Fluoruros Tópicos/farmacologíaRESUMEN
Cavernous malformations (CMs) account for 10%-15% of all vascular malformations and represent the second most common type of cerebral vascular lesion.1 They typically occur in the cerebral subcortex or white matter.2 CMs located in the thalamus are rare.3 When we isolate the group of thalamic CMs, we find a bleeding risk of >5% per year, with a rebleeding rate exceeding 60%, often occurring within 1 year of the initial bleeding.1 The deep location and proximity to eloquent brain regions make thalamic CMs challenging for neurosurgeons.4,5 Surgeons can access the posterolateral thalamus through various surgical approaches, such as transcallosal transventricular, supracerebellar transtentorial, intraparietal sulcus, and transcortical methods. Selecting the best surgical approach requires considerable expertise, considering the patient's preoperative condition and the lesion's location.6-12 We discuss a complex case involving a 24-year-old patient with a right thalamic cavernoma and a history of 3 prior bleeding events. We present a step-by-step transcortical approach through the posterior portion of the superior temporal gyrus (Video 1). The patient consented to the procedure and publication of images. We demonstrate how the transtemporal posterior trajectory provides an optimal working corridor for safely removing this cavernous malformation without introducing new deficits.
Asunto(s)
Hemangioma Cavernoso del Sistema Nervioso Central , Procedimientos Neuroquirúrgicos , Tálamo , Humanos , Hemangioma Cavernoso del Sistema Nervioso Central/cirugía , Hemangioma Cavernoso del Sistema Nervioso Central/diagnóstico por imagen , Tálamo/cirugía , Tálamo/diagnóstico por imagen , Procedimientos Neuroquirúrgicos/métodos , Adulto JovenRESUMEN
BACKGROUND AND OBJECTIVES: Transorbital ventricular puncture is a minimally invasive described procedure with poor landmarks and anatomic references. This approach can be easily performed to save patients with intracranial hypertension, especially when it is secondary to an acute decompensated hydrocephalus. This study aims to describe anatomic structures and landmarks to facilitate the execution of transorbital puncture in emergency cases. METHODS: We analyzed 120 head computed tomographies to show the best area to perform the procedure in the orbital roof. Two adult cadavers (4 sides) were punctured in the predetermined area. Angles, distances, landmarks, and anatomic structures were registered. This approach to the ventricular system may be performed at bedside to relieve intracranial hypertension only in specific cases. RESULTS: The perforation point is 2.5 cm (female) or 3.0 cm (male) lateral to the midline and immediately inferior to the superciliary arch. A vertical line, parallel to midline, was drawn on the outer edge of the patient's forehead, the needle was 45° inferiorly and 20° medially and then progressed 2.0 cm backwards to reach the bone perforation point. After that, it was advanced another 4.5cm approximately until it reached the anterior horn of the lateral ventricle. CONCLUSION: Based on statistical and experimental evidences, we were able to establish reliable anatomic reference points to access the anterior horn of the lateral ventricle through transorbital puncture.
Asunto(s)
Cabeza , Hipertensión Intracraneal , Adulto , Humanos , Masculino , Femenino , Ventrículos Cerebrales/diagnóstico por imagen , Ventrículos Cerebrales/cirugía , Tomografía Computarizada por Rayos X , PuncionesRESUMEN
BACKGROUND: Neurosurgical training continuously seeks innovative methods to enhance the acquisition of essential technical skills for neurosurgeons worldwide. While various training models have been employed, few truly replicate real-life conditions optimally. Human placenta is a good model for neurosurgical microsurgery training due to its anatomic similarities to neurovascular structures. Placental vessels exhibit a branching pattern and caliber comparable with intracranial vessels, making them suitable for practicing microsurgical techniques. The study aims to delineate the anatomic zones of the placenta and propose a segmented training model, resulting in a reproducible, cost-effective, and realistic neurosurgical microsurgery training environment. METHODS: Twenty human placentas were meticulously prepared, injected with dyes, and categorized into zones on the basis of anatomic features. Measurements of placental vessels were recorded and compared with cerebral vessels. The placenta was divided into 4 quadrants to facilitate specific training techniques. RESULTS: Our results revealed varying vessel diameters across placental zones, closely resembling cerebral vessels. Different microsurgical techniques were applied to specific placental zones, thereby optimizing training scenarios. The applicability section described exercises such as membrane dissection, vessel skeletonization, aneurysm creation, vascular bypass, and tumor dissection within the placental model, providing detailed guidance on the zones suitable for each exercise. CONCLUSIONS: Human placenta serves as an effective microsurgical training model for neurosurgery, enhancing neurosurgeons' skills through anatomic segmentation. Integrating this model into training programs can significantly contribute to skill acquisition and improved surgical outcomes. Further research is warranted to refine and expand its utilization, complemented by clinical experiences and other simulation tools.
Asunto(s)
Neurocirugia , Placenta , Humanos , Embarazo , Femenino , Placenta/irrigación sanguínea , Modelos Anatómicos , Microcirugia/métodos , Neurocirugia/educación , Procedimientos Neuroquirúrgicos/métodos , Competencia ClínicaRESUMEN
4D Light Field (LF) imaging, since it conveys both spatial and angular scene information, can facilitate computer vision tasks and generate immersive experiences for end-users. A key challenge in 4D LF imaging is to flexibly and adaptively represent the included spatio-angular information to facilitate subsequent computer vision applications. Recently, image over-segmentation into homogenous regions with perceptually meaningful information has been exploited to represent 4D LFs. However, existing methods assume densely sampled LFs and do not adequately deal with sparse LFs with large occlusions. Furthermore, the spatio-angular LF cues are not fully exploited in the existing methods. In this paper, the concept of hyperpixels is defined and a flexible, automatic, and adaptive representation for both dense and sparse 4D LFs is proposed. Initially, disparity maps are estimated for all views to enhance over-segmentation accuracy and consistency. Afterwards, a modified weighted K -means clustering using robust spatio-angular features is performed in 4D Euclidean space. Experimental results on several dense and sparse 4D LF datasets show competitive and outperforming performance in terms of over-segmentation accuracy, shape regularity and view consistency against state-of-the-art methods.
RESUMEN
In this study, we investigated the influence of mixture design on the chemical profile of Eugenia unifloraleaves, evaluating the antioxidant and antimicrobial activities, the toxic and hemolytic potential, with the focus on the improvement of the polyphenol's extraction for incorporation of the extract in semi-solid forms with antifungal action. The chemical analysis was evaluated by UV-Vis and HPLC. The antimicrobial, antioxidant, and hemolytic activities were monitored. The flavonoid content ranged from 2.63-7.98 %w/w and tannins from 5.42-18.29 %w/w. The extract consisted of gallic acid (0.09-1.29%; w/w), ellagic acid (0.09-0.37%; w/w), and myricitrin (0.18-1.20%; w/w). The most successful solvent system with the highest level of active extract was water: ethanol: propylene glycol. The extracts showed fungicidal properties (3.9 µg/mL), high antioxidant activity (IC50: 9.50 µg/mL), and low toxicity. These solvent mixtures can improve the in vitro bioactivities when compared to pure solvents and this result demonstrates the importance of mixture designs as useful tools for creating high-quality herbal products and elucidate the potential of E. uniflora glycolic extracts as active herbal pharmaceutical ingredients in topical delivery systems.
En este estudio investigamos la influencia del diseño de mezclas en el perfil químico de hojas de Eugenia uniflora, evaluando las actividades antioxidantes y antimicrobianas, el potencial tóxico y hemolítico, con el foco en la mejora de la extracción de polifenoles para la incorporación del extracto en formas semi-sólidas con acción antifúngica. El análisis químico se evaluó mediante UV-Vis y HPLC. Se monitorizaron las actividades antimicrobianas, antioxidantes y hemolíticas. El contenido de flavonoides osciló entre 2,63 y 7,98% p/p and taninos de 5,42-18,29% p/p. El extracto consistió en ácido gálico (0.09-1.29%; p/p), ácido elágico (0.09-0.37%; p/p) y miricitrina (0.18-1.20%; p/p). El sistema de disolventes más exitoso con el nivel más alto de extracto activo fue agua: etanol: propilenglicol. Los extractos mostraron propiedades fungicidas (3.9 µg/mL), alta actividad antioxidante (IC50: 9.50 µg/mL) y baja toxicidad. Estas mezclas de disolventes pueden mejorar las bioactividades in vitro en comparación con los disolventes puros y este resultado demuestra la importancia de los diseños de mezclas como herramientas útiles para crear productos a base de hierbas de alta calidad y dilucidar el potencial de los extractos glicólicos de E. uniflora como ingredientes farmacéuticos a base de hierbas en sistemas de entrega activos.
Asunto(s)
Extractos Vegetales/química , Eugenia/química , Extractos Vegetales/toxicidad , Extractos Vegetales/farmacología , Fitoquímicos , AntiinfecciososRESUMEN
Regulatory T cells (Tregs) normally maintain self-tolerance. Tregs recognize "self" such that when they are not working properly, such as in autoimmunity, the immune system can attack and destroy one's own tissues. Current therapies for autoimmunity rely on relatively ineffective and too often toxic therapies to "treat" the destructive inflammation. Restoring defective endogenous immune regulation (self-tolerance) would represent a paradigm shift in the therapy of these diseases. One recent approach to restore self-tolerance is to use "low dose IL-2" as a therapy to increase the number of circulating Tregs. However, studies to-date have not demonstrated that low-dose IL-2 therapy can restore concomitant Treg function, and phase 2 studies in low dose IL-2 treated patients with autoimmune diseases have failed to demonstrate significant clinical benefit. We hypothesize that the defect in self-tolerance seen in autoimmunity is not due to an insufficient number of available Tregs, but rather, due to defects in second messengers downstream of the IL-2R that normally control Treg function and stability. Previous studies from our lab and others have demonstrated that GRAIL (a ubiquitin E3 ligase) is important in Treg function. GRAIL expression is markedly diminished in Tregs from patients with autoimmune diseases and allergic asthma and is also diminished in Tregs of mice that are considered autoimmune prone. In the relevant pathway in Tregs, GRAIL normally blocks cullin ring ligase activity, which inhibits IL-2R desensitization in Tregs and consequently promotes Treg function. As a result of this defect in GRAIL expression, the Tregs of patients with autoimmune diseases and allergic asthma degrade IL-2R-associated pJAK1 following activation with low dose IL-2, and thus cannot maintain pSTAT5 expression. pSTAT5 controls the transcription of genes required for Treg function. Additionally, the GRAIL-mediated defect may also allow the degradation of the mTOR inhibitor, DEP domain-containing mTOR interacting protein (Deptor). This can lead to IL-2R activation of mTOR and loss of Treg stability in autoimmune patients. Using a monoclonal antibody to the remnant di-glycine tag on ubiquitinated proteins after trypsin digestion, we identified a protein that was ubiquitinated by GRAIL that is important in Treg function, cullin5. Our data demonstrate that GRAIL acts a negative regulator of IL-2R desensitization by ubiquitinating a lysine on cullin5 that must be neddylated to allow cullin5 cullin ring ligase activity. We hypothesize that a neddylation inhibitor in combination with low dose IL-2 activation could be used to substitute for GRAIL and restore Treg function and stability in the Tregs of autoimmune and allergic asthma patients. However, the neddylation activating enzyme inhibitors (NAEi) are toxic when given systemically. By generating a protein drug conjugate (PDC) consisting of a NAEi bound, via cleavable linkers, to a fusion protein of murine IL-2 (to target the drug to Tregs), we were able to use 1000-fold less of the neddylation inhibitor drug than the amount required for therapeutically effective systemic delivery. The PDC was effective in blocking the onset or the progression of disease in several mouse models of autoimmunity (type 1 diabetes, systemic lupus erythematosus, and multiple sclerosis) and a mouse model of allergic asthma in the absence of detectable toxicity. This PDC strategy represents targeted drug delivery at its best where the defect causing the disease was identified, a drug was designed and developed to correct the defect, and the drug was targeted and delivered only to cells that needed it, maximizing safety and efficacy.
Asunto(s)
Enfermedades Autoinmunes , Linfocitos T Reguladores , Ratones , Animales , Interleucina-2/metabolismo , Proteínas Cullin/metabolismo , Receptores de Interleucina-2 , Enfermedades Autoinmunes/metabolismo , Serina-Treonina Quinasas TOR/metabolismoRESUMEN
Among the policies for the creation of protected areas, the "Park" category is the best known worldwide. In Brazil, the national parks are important areas for the conservation of biodiversity and for ecotourism, but twenty years after the enactment of the law that regulates the National System of Protected Areas, there is no clear scenario of the National Parks' current situation regarding the fulfillment of their legal objectives. Aiming to understand this scenario in the six main Brazilian biomes, we evaluated variables related to: level of land regularization, existence and updating of management plans, number of authorized scientific research studies, variation in the number of visitors, development of recreation activities, ecotourism, and existence of an Advisory Council. For all biomes, the results regarding the legal objectives' attainment are negative, mostly in terms of land regularization, with the worst results being found in the Caatinga biome < 2% of the area within parks regularized. We concluded that only in specific cases the legal objectives of these protected areas are being accomplished and, therefore, if we keep the pace and the implementation and management policies of the last 20 years, the outlook is pessimistic for the conservation of Brazilian biodiversity.
Asunto(s)
Parques Recreativos , BrasilRESUMEN
There are many applications in which quantitative information about DNA mixtures with different molecular lengths is important. Gene therapy vectors are much longer than can be sequenced individually via short-read NGS. However, vector preparations may contain smaller DNAs that behave differently during sequencing. We have used two library preparations each for Pacific Biosystems (PacBio) and Oxford Nanopore Technologies NGS to determine their suitability for quantitative assessment of varying sized DNAs. Equimolar length standards were generated from E. coli genomic DNA. Both PacBio library preparations provided a consistent length dependence though with a complex pattern. This method is sufficiently sensitive that differences in genomic copy number between DNA from E. coli grown in exponential and stationary phase conditions could be detected. The transposase-based Oxford Nanopore library preparation provided a predictable length dependence, but the random sequence starts caused the loss of original length information. The ligation-based approach retained length information but read frequency was more variable. Modeling of E. coli versus lambda read frequency via cubic spline smoothing showed that the shorter genome could be used as a suitable internal spike-in for DNAs in the 200 bp to 10 kb range, allowing meaningful QC to be carried out with AAV preparations.
Asunto(s)
Escherichia coli , Secuenciación de Nucleótidos de Alto Rendimiento , Secuenciación de Nucleótidos de Alto Rendimiento/métodos , Calibración , Análisis de Secuencia de ADN/métodos , ADNRESUMEN
In the current work, we describe the synthesis of 1,4-dihydropyridine (1,4-DHP) derivatives via Hantzsch multicomponent reaction and their evaluation as photosystemâ II (PSII) inhibitors through chlorophyll a fluorescence bioassay. Among all the compounds tested, 1,1'-(2,4,6-trimethyl-1,4-dihydropyridine-3,5-diyl)bis(ethan-1-one) (4b) showed best results, reducing the parameters performance index on absorption basis (PIabs ) and electron transport per reaction center by 61 % and 49 %, respectively, as compared to the control. These results indicate the inhibitory activity of PSII over the electron transport chain. Additionally, a molecular docking approach using the protein D1 (PDB code 4V82) was performed in order to assess the structure-activity relationship among the 1,4-DHP derivatives over the PSII, which revealed that both, size of the group at position 4 and the carbonyl groups at the dihydropyridine ring are important for the ligand's interaction, particularly for the hydrogen-bonding interaction with the residues His215, Ser264, and Phe265. Thus, the optimization of these molecular features is the aim of our research group to extend the knowledge of PSII electron chain inhibitors and the establishment of new potent bioactive molecular scaffolds.
Asunto(s)
Herbicidas , Herbicidas/farmacología , Herbicidas/química , Simulación del Acoplamiento Molecular , Clorofila A , Fotosíntesis , Complejo de Proteína del Fotosistema II , Clorofila/químicaRESUMEN
Cerebral arteriovenous malformations (AVMs) are dynamic neurovascular disorders that occur mainly in young adults, presenting an annual risk of rupture of 2% - 4% per year.1 They can be asymptomatic, representing an incidental radiologic finding, or present with neurologic deficits according to their brain location, size, and presence or absence of bleeding.2,3 AVMs located in eloquent areas4 represent a great challenge for neurosurgeons, sometimes directed to alternatives therapies (e.g., embolization, radiotherapy) due to the difficulty in planning and surgical technique. Despite the complexity, we consider that there is benefit to removing these lesions; this can be done safely, as with the adequate microsurgical strategy and neuroanatomic knowledge. In Video 1, we show the case of a 55-year-old male patient with an AVM positioned over the right central sulcus. He presented with intermittent left-hand paresthesia followed by an episode of involuntary movements in the left arm without loss of consciousness and with spontaneous resolution. Angiography showed an AVM feed by branches of the middle cerebral artery and multiple venous drainage for the Trolard complex and superficial middle cerebral vein, with a 4-cm nidus, making it grade III in the Spetzler-Martin classification.4 The patient underwent surgery with total resection of the lesion without any complication or new neurologic deficits.
Asunto(s)
Embolización Terapéutica , Malformaciones Arteriovenosas Intracraneales , Humanos , Malformaciones Arteriovenosas Intracraneales/complicaciones , Malformaciones Arteriovenosas Intracraneales/diagnóstico por imagen , Malformaciones Arteriovenosas Intracraneales/cirugía , Masculino , Microcirugia/métodos , Persona de Mediana Edad , Procedimientos Neuroquirúrgicos , Resultado del Tratamiento , Adulto JovenRESUMEN
The prevention and treatment of erosive tooth wear are becoming increasingly important due to its increasing prevalence. The use of natural solutions to modify dental surfaces has become an area of research. Organic materials such as chitosan and hydrolyzed collagen may be a promising option to treat dentin. This in vitro study aimed to evaluate the influence of chitosan or hydrolyzed collagen, alone or combined with acidulated phosphate fluoride (APF) gel, on the composition and morphology of dentin after erosion. Bovine dentin samples were prepared (n = 84) and treated with artificial saliva (AS, negative control); APF gel (F, positive control); chitosan solution (Chi); hydrolyzed collagen solution (Col); fluoride/chitosan composition (F_Chi); and fluoride/hydrolyzed collagen composition (F_Col). Erosive cycles (six cycles of immersion in orange juice for 1 min, followed by immersion in AS for 1 hr) were performed. The materials were characterized by their morphology, composition, and particle size distribution. Micro-energy dispersive X-ray fluorescence spectroscopy and scanning electron were used to evaluate the dentin's inorganic chemical composition and morphology. The F_Col and F groups had a reduction in calcium loss by 17 and 26%, respectively (p < .001). Both of these groups still had a covering layer of agglomerates at the dentin surface after the erosive cycles. The fluoridated chitosan or collagen solutions improved the dentin resistance to erosion as a novel hybrid-fluoride-based material approach to provide surface protection from erosion.
Asunto(s)
Quitosano , Erosión de los Dientes , Animales , Biomineralización , Bovinos , Quitosano/farmacología , Colágeno/análisis , Dentina/química , Fluoruros/farmacología , Erosión de los Dientes/tratamiento farmacológico , Erosión de los Dientes/prevención & controlRESUMEN
BACKGROUND AND AIM: Among the most common symptoms of COVID-19 is taste dysfunction, which has a ranging clinical presentation. As well as its pathophysiology remains to be unclear, there is not enough information about the efficacy and safety of the available treatments. This study aims to report a series of cases using PBMT for the management of COVID-19-related taste impairment. CASE SERIES: 8 female and 2 male patients sought medical help for taste impairment (either partially or completely) after COVID-19 infection. Photobiomodulation therapy (PBMT) on the tongue mucosa was then proposed but with 3 different protocols. Taste perception at baseline and before every laser session was evaluated using a visual analog scale. Irrespective of the PBMT protocol, taste recovery was noted in all cases but with varying degrees of improvement. CONCLUSION: given the high prevalence rates of taste dysfunction in COVID-19 patients and the lack of information about the available treatments, PBMT seems to be a promising therapeutic modality but not dependent on the total number of laser sessions and the interval between them. The choice of the most suitable laser protocol as well as the knowledge of the exact photonic mechanisms, however, need to be better studied.
Asunto(s)
COVID-19 , Terapia por Luz de Baja Intensidad , Fotoquimioterapia , Femenino , Humanos , Terapia por Luz de Baja Intensidad/métodos , Masculino , Fotoquimioterapia/métodos , SARS-CoV-2 , Trastornos del Gusto/etiologíaRESUMEN
Several pathologies can alter the way people walk, i.e., their gait. Gait analysis can be used to detect such alterations and, therefore, help diagnose certain pathologies or assess people's health and recovery. Simple vision-based systems have a considerable potential in this area, as they allow the capture of gait in unconstrained environments, such as at home or in a clinic, while the required computations can be done remotely. State-of-the-art vision-based systems for gait analysis use deep learning strategies, thus requiring a large amount of data for training. However, to the best of our knowledge, the largest publicly available pathological gait dataset contains only 10 subjects, simulating five types of gait. This paper presents a new dataset, GAIT-IT, captured from 21 subjects simulating five types of gait, at two severity levels. The dataset is recorded in a professional studio, making the sequences free of background camouflage, variations in illumination and other visual artifacts. The dataset is used to train a novel automatic gait analysis system. Compared to the state-of-the-art, the proposed system achieves a drastic reduction in the number of trainable parameters, memory requirements and execution times, while the classification accuracy is on par with the state-of-the-art. Recognizing the importance of remote healthcare, the proposed automatic gait analysis system is integrated with a prototype web application. This prototype is presently hosted in a private network, and after further tests and development it will allow people to upload a video of them walking and execute a web service that classifies their gait. The web application has a user-friendly interface usable by healthcare professionals or by laypersons. The application also makes an association between the identified type of gait and potential gait pathologies that exhibit the identified characteristics.
RESUMEN
Olfactory dysfunction is commonly seen in COVID-19 patients; however, little is known about the pathophysiology and management. The present study aimed to report a series of cases in which three protocols of intranasal photobiomodulation therapy (PBMT) were used for COVID-19-related olfactory dysfunction. Irrespective of the PBMT protocol, olfaction recovery was noted in all cases but with varying degrees of improvement. Although intranasal PBMT seems to be a promising therapeutic modality, more research is needed to better define effectiveness.