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1.
NPJ Breast Cancer ; 10(1): 10, 2024 Jan 20.
Artículo en Inglés | MEDLINE | ID: mdl-38245552

RESUMEN

Accurate prediction of response to neoadjuvant chemotherapy (NAC) can help tailor treatment to individual patients' needs. Little is known about the combination of liquid biopsies and computer extracted features from multiparametric magnetic resonance imaging (MRI) for the prediction of NAC response in breast cancer. Here, we report on a prospective study with the aim to explore the predictive potential of this combination in adjunct to standard clinical and pathological information before, during and after NAC. The study was performed in four Dutch hospitals. Patients without metastases treated with NAC underwent 3 T multiparametric MRI scans before, during and after NAC. Liquid biopsies were obtained before every chemotherapy cycle and before surgery. Prediction models were developed using penalized linear regression to forecast residual cancer burden after NAC and evaluated for pathologic complete response (pCR) using leave-one-out-cross-validation (LOOCV). Sixty-one patients were included. Twenty-three patients (38%) achieved pCR. Most prediction models yielded the highest estimated LOOCV area under the curve (AUC) at the post-treatment timepoint. A clinical-only model including tumor grade, nodal status and receptor subtype yielded an estimated LOOCV AUC for pCR of 0.76, which increased to 0.82 by incorporating post-treatment radiological MRI assessment (i.e., the "clinical-radiological" model). The estimated LOOCV AUC was 0.84 after incorporation of computer-extracted MRI features, and 0.85 when liquid biopsy information was added instead of the radiological MRI assessment. Adding liquid biopsy information to the clinical-radiological resulted in an estimated LOOCV AUC of 0.86. In conclusion, inclusion of liquid biopsy-derived markers in clinical-radiological prediction models may have potential to improve prediction of pCR after NAC in breast cancer.

2.
Hernia ; 27(6): 1429-1437, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-37847334

RESUMEN

INTRODUCTION: Inguinal hernia repair is one of the most commonly performed operations in general surgery. A total of 130.000 inguinal hernia repairs are performed yearly in Italy, and approximately 20 million inguinal hernias are treated worldwide annually. This report represents the trend analysis in inguinal hernia repair in Italy from a nationwide dataset for the 6-year period from 2015 to 2020. MATERIALS AND METHODS: Based on regional hospital discharge records, all the inguinal hernia repairs performed in public and private hospitals in Italy between 2015 and 2020 were reviewed based on diagnosis and procedure codes. For the aim of this study, data from the AgeNas (The National Agency for Regional Health Services) data source were analyzed. RESULTS: Elective inguinal hernia repairs outnumbered urgent operations over the 6-year study period, ranging from 122,737 operations in 2015 to 65,780 in 2020 as absolute numbers, and from 87.96 to 83.3% of total procedures in 2019 and 2020 respectively, with an annual change ranging from - 66.58%, between 2020 and 2019, to - 2.49%, between 2019 and 2018 (mean = - 18.74%; CI =- 46.7%-9.22%; p < 0.0001). CONCLUSIONS: This large-scale review of groin hernia data from a nationwide Italian dataset provides a unique opportunity to obtain a snapshot of open groin hernia repair activity. More specifically, there is a trend to perform more elective than urgent procedures and there is a steady decrease in the amount of open hernia repairs in favor to laparoscopy.


Asunto(s)
Hernia Inguinal , Laparoscopía , Humanos , Hernia Inguinal/cirugía , Herniorrafia/métodos , Ingle/cirugía , Laparoscopía/métodos , Italia/epidemiología
3.
Food Res Int ; 170: 113010, 2023 08.
Artículo en Inglés | MEDLINE | ID: mdl-37316077

RESUMEN

Dysphagia is a condition that affects the ability to chew and swallow food and beverages, having a major impact on people's health and wellbeing. This work developed gel systems with a customized texture suitable for intake by dysphagic people using 3D printing and milk. Gels were developed using skim powdered milk, cassava starch (native and modified by the Dry Heating Treatment (DHT)), and different concentrations of kappa-carrageenan (ĸC). The gels were evaluated in relation to the starch modification process and concentration of gelling agents, 3D printing performance, and suitability for dysphagic people (following both the standard fork test described by the International Dysphagia Diet Standardization Initiative (IDDSI), and also using a new device coupled to a texture analyzer). Moreover, the best formulations were evaluated for mineral bioaccessibility through simulated gastrointestinal digestion based on INFOGEST 2.0 standardized method. The results showed that ĸC had a dominant effect compared to the DHT-modified starch on gel texture, 3D printing performance, and fork tests. The gels obtained by molding or 3D printing resulted in different behaviors during the fork test, which was associated with the gel extrusion process that breaks down their initial structure. The strategies applied to tailor the texture of the milk did not affect the mineral bioaccessibility, which was kept high (>80%).


Asunto(s)
Trastornos de Deglución , Leche , Humanos , Animales , Almidón , Carragenina , Geles , Minerales , Impresión Tridimensional
4.
J Biomol Struct Dyn ; 41(24): 14871-14886, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36927332

RESUMEN

The present study focused on investigating the antioxidant, antiglycation activity, digestive enzymes inhibition, bioaccessibility and hypoglycemic effect of C. arabica leaves extracts. The extracts deactivated the O2•-, ROO•, H2O2, HOCl reactive oxygen species. Coffee leaves showed strong inhibition of α-glucosidase (IC50 = 40.30 µg mL-1) greater than the isolated metabolites and acarbose. There was also inhibition of pancreatic lipase (IC50 = 56.43 µg mL-1) in addition to a hypoglycemic effect in zebrafish similar to acarbose and metformin. With the exception of rutin, all biocompounds were detected at all stages of in vitro digestion. Finally, these results suggest that C. arabica leaf extracts possess antidiabetic and anti-obesity properties that can be attributed to the main metabolites and the synergistic action between them.Communicated by Ramaswamy H. Sarma.


Asunto(s)
Antioxidantes , Coffea , Animales , Antioxidantes/farmacología , Hipoglucemiantes/farmacología , Extractos Vegetales/farmacología , Acarbosa , Peróxido de Hidrógeno , Pez Cebra
5.
Hernia ; 27(3): 485-501, 2023 06.
Artículo en Inglés | MEDLINE | ID: mdl-35618958

RESUMEN

PURPOSE: Minimally invasive approach for acute incarcerated groin hernia repair is still debated. To clarify this debate, a literature review was performed. METHODS: Search was performed in PubMed, Embase, Scopus, Web of Science, and Cochrane databases, founding 28,183 articles. RESULTS: Fifteen articles, and 433 patients were included (16 bilateral hernia, range 3-8). Three hundred and eighty-eight (75.3%) and 103 patients (22.9%) underwent transabdominal preperitoneal and totally extraperitoneal repair, respectively, and in 5 patients, the defect was buttressed with broad ligament (1.1%) (not specified in 3 patients). Herniated structures were resected in 48 cases (range 1-9). Intraoperative complications and conversion occurred in 4 (range 0-1) and 10 (range 0-3) patients, respectively. Mean operative time and hospital stay ranged between 50 and 147 min, and 2 and 7 days, respectively. Postoperative complications ranged between 1 and 19. Five studies compared laparoscopic and open approaches (163 and 235 patients). Herniated structures were resected in 19 (11.7%) and 42 cases (17.9%) for laparoscopic and open approach, respectively (p = 0.1191). Intraoperative complications and conversion occurred in one (0.6%) and 5 (2.1%) patients (p = 0.4077), and in two (1.2%) and 19 (8.1%) patients (p = 0.0023), in case of laparoscopic or open approach, respectively. Mean operative time and hospital stay were 94.4 ± 40.2 and 102.8 ± 43.7 min, and 4.8 ± 2.2 and 11 ± 3.1 days, in laparoscopic or open approach, respectively. Sixteen (9.8%) and 57 (24.3%) postoperative complications occurred. CONCLUSION: Laparoscopy seems to be a safe and feasible approach for the treatment of acute incarcerated groin hernia. Further studies are required for definitive conclusions.


Asunto(s)
Hernia Inguinal , Laparoscopía , Femenino , Humanos , Resultado del Tratamiento , Ingle/cirugía , Herniorrafia/efectos adversos , Hernia Inguinal/cirugía , Hernia Inguinal/complicaciones , Laparoscopía/efectos adversos , Complicaciones Posoperatorias/etiología , Complicaciones Intraoperatorias , Mallas Quirúrgicas/efectos adversos
6.
Dig Liver Dis ; 55(4): 534-540, 2023 04.
Artículo en Inglés | MEDLINE | ID: mdl-36369195

RESUMEN

BACKGROUND: Cholangiocarcinoma (CCA) is a rare biliary tract tumor with poor prognosis that often is challenging to diagnose and the majority of patients present with advanced stage. Squamous cell carcinoma antigen 1 (SCCA1) overexpression has been found in different tumors associated with poor prognosis and chemoresistance. AIMS: To assess the presence and possible prognostic role of SCCA1/2 isoforms in bile and serum of patients with CCA. METHODS: Forty seven surgical patients (36 with CCA and 11 with benign diseases) were prospectively included in the study. Serum and bile specimens were collected at the time of surgery and free and IgM-complexed SCCA was quantified by ELISA (Xeptagen, srl). RESULTS: Free or IgM linked SCCA was rarely found in serum, while SCCA was detectable in bile samples of patients with CCA, especially in those with extrahepatic form (43% vs 17%, p = 0.008), but not in controls. Despite similar tumor stage, these positive patients presented a trend toward a higher percentage of portal invasion (27% vs 15%) and of tumor recurrence than negative cases (62% vs 40%), although the difference was not statistically significant. CONCLUSION: These preliminary results indicate that bile testing for SCCA is a specific marker of extrahepatic CCA, with potential prognostic value.


Asunto(s)
Neoplasias de los Conductos Biliares , Colangiocarcinoma , Neoplasias Hepáticas , Humanos , Bilis , Biomarcadores de Tumor , Recurrencia Local de Neoplasia , Neoplasias Hepáticas/diagnóstico , Colangiocarcinoma/diagnóstico , Inmunoglobulina M , Neoplasias de los Conductos Biliares/diagnóstico
7.
Braz. j. biol ; 81(3): 665-673, July-Sept. 2021. tab, graf
Artículo en Inglés | LILACS | ID: biblio-1153396

RESUMEN

Abstract Educational interventions may trigger actions that contribute to prevent parasitic diseases, such as Chagas disease (CD). This study aimed at investigating the impact of an instructional video named "Documentary on Chagas Disease" on knowledge about CD and its vectors displayed by a population that lives in an endemic area in Brazil, so as to validate it as an educational tool. The video was shown to 226 subjects, divided into two groups. Group 1 was composed of users of Basic Health Units (BHU) in Pelotas and Pinheiro Machado, cities located in Rio Grande do Sul (RS) state, Brazil, where CD is endemic. Group 2 consisted of students who attend three public schools located in the rural area in Pinheiro Machado, RS. Two questionnaires with questions about their knowledge about triatomines and CD were applied, before and after the documentary was shown. After the video was shown, there was significant increase in individuals' knowledge (in both groups) about "kissing bugs", their notification, the disease and its prevention. Besides, watchers considered that the quality of the material was satisfactory. Since the "Documentary on CD" can be easily accessed on the internet and was effective in teaching the population that lives in endemic areas, its use should be encouraged in places and meetings connected to health that aim at fighting against triatominae and at exposing an updated view of CD.


Resumo Intervenções educacionais podem desencadear ações que contribuam para a prevenção de doenças parasitárias, como a doença de Chagas (DC). Este estudo teve como objetivo investigar o impacto de um vídeo instrucional denominado "Documentário Doença de Chagas" no conhecimento sobre DC e seus vetores exibidos a uma população que vive em área endêmica no Brasil, para validá-lo como uma ferramenta educacional. O vídeo foi exibido para 226 indivíduos, divididos em dois grupos. O grupo 1 foi composto por usuários das Unidades Básicas de Saúde (UBS) de Pelotas e Pinheiro Machado, cidades do estado do Rio Grande do Sul (RS), Brasil, onde a DC é endêmica. O grupo 2 foi formado por estudantes que frequentam três escolas públicas localizadas na zona rural de Pinheiro Machado, RS. Dois questionários com perguntas sobre conhecimentos sobre triatomíneos e DC foram aplicados, antes e depois da exibição do documentário. Após a exibição do vídeo, houve um aumento significativo no conhecimento dos indivíduos (em ambos os grupos) sobre "triatomíneos", sua notificação, a doença e sua prevenção. Além disso, os observadores consideraram que a qualidade do material era satisfatória. Como o "Documentário DC" pode ser facilmente acessado na Internet e ser eficaz no ensino à população que vive em áreas endêmicas, seu uso deve ser incentivado em locais e reuniões relacionadas à saúde, que visam combater os triatomíneos e exibir uma informação atualizada sobre a DC.


Asunto(s)
Humanos , Animales , Triatoma , Triatominae , Enfermedad de Chagas/epidemiología , Brasil/epidemiología , Insectos Vectores
8.
Hernia ; 25(2): 501-521, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-32683579

RESUMEN

PURPOSE: Although many studies assessing enhanced recovery after surgery (ERAS) pathways in abdominal wall reconstruction (AWR) have recently demonstrated lower rates of postoperative morbidity and a decrease in postoperative length of stay compared to standard practice, the utility of ERAS in AWR remains largely unknown. METHODS: A systematic literature search for randomized and non-randomized studies comparing ERAS (ERAS +) pathways and standard protocols (Control) as an adopted practice for patients undergoing AWR was performed using MEDLINE, the Cochrane Central Register of Controlled Trials, Scopus, Web of Science, and EMBASE databases. A predefined search strategy was implemented. The included studies were reviewed for primary outcomes: overall postoperative morbidity, abdominal wall morbidity, surgical site infection (SSI), and length of hospital stay; and for secondary outcome: operative time, estimated blood loss, time to discontinuation of narcotics, time to urinary catheter removal, time to return to bowel function, time to return to regular diet, and readmission rate. Standardized mean difference (SMD) was calculated for continuous variables and Odds Ratio for dichotomous variables. RESULTS: Five non-randomized studies were included for qualitative and quantitative synthesis. 840 patients were allocated to either ERAS + (382) or Control (458). ERAS + and Control groups showed equivalent results with regard to the incidence of postoperative morbidity (OR 0.73, 95% CI 0.32-1.63; I2= 76%), SSI (OR 1.17, 95% CI 0.43-3.22; I2= 54%), time to return to bowel function (SMD - 2.57, 95% CI - 5.32 to 0.17; I2= 99%), time to discontinuation of narcotics (SMD - 0.61, 95% CI - 1.81 to 0.59; I2= 97%), time to urinary catheter removal (SMD - 2.77, 95% CI - 6.05 to 0.51; I2= 99%), time to return to regular diet (SMD - 0.77, 95% CI - 2.29 to 0.74; I2= 98%), and readmission rate (OR 0.82, 95% CI 0.52-1.27; I2= 49%). Length of hospital stay was significantly shorter in the ERAS + compared to the Control group (SMD - 0.93, 95% CI - 1.84 to - 0.02; I2= 97%). CONCLUSIONS: The introduction of an ERAS pathway into the clinical practice for patients undergoing AWR may cause a decreased length of hospitalization. These results should be interpreted with caution, due to the low level of evidence and the high heterogeneity.


Asunto(s)
Pared Abdominal , Abdominoplastia , Recuperación Mejorada Después de la Cirugía , Pared Abdominal/cirugía , Herniorrafia , Humanos , Tiempo de Internación , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología
9.
J Eur Acad Dermatol Venereol ; 35(2): 396-402, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32564428

RESUMEN

BACKGROUND: Nevoid basal cell carcinoma syndrome (NBCCS) is an autosomal dominant genetic disorder. It is commonly caused by mutations in PTCH1 and chiefly characterized by multiple basal cell carcinomas (BCCs) developing prior to the age of 30 years. In rare cases, NBCCS presents with a late onset of BCC development. OBJECTIVE: To investigate BCC tumorigenesis in two brothers, who showed characteristic features of NBCCS but developed their first BCCs only after the age of 40 years. Two other siblings did not show signs of NBCCS. RESULTS: We obtained blood samples from four siblings and nine BCCs from the two brothers with NBCCS. Whole exome sequencing and RNA sequencing revealed loss of heterozygosity (LOH) of PTCH1 in eight out of nine tumours that consistently involved the same haplotype on chromosome 9. This haplotype contained a germinal splice site mutation in PTCH1 (NM_001083605:exon9:c.763-6C>A). Analysis of germline DNA confirmed segregation of this mutation with the disease. All BCCs harboured additional somatic loss-of-function (LoF) mutations in the remaining PTCH1 allele which are not typically seen in other cases of NBCCS. This suggests a hypomorphic nature of the germinal PTCH1 mutation in this family. Furthermore, all BCCs had a similar tumour mutational burden compared to BCCs of unrelated NBCCS patients while harbouring a higher number of damaging PTCH1 mutations. CONCLUSIONS: Our data suggest that a sequence of three genetic hits leads to the late development of BCCs in two brothers with NBCCS: a hypomorphic germline mutation, followed by somatic LOH and additional mutations that complete PTCH1 inactivation. These genetic events are in line with the late occurrence of the first BCC and with the higher number of damaging PTCH1 mutations compared to usual cases of NBCCS.


Asunto(s)
Síndrome del Nevo Basocelular , Carcinoma Basocelular , Neoplasias Cutáneas , Adulto , Síndrome del Nevo Basocelular/genética , Carcinoma Basocelular/genética , Genómica , Humanos , Masculino , Receptores Patched , Receptor Patched-1/genética , Hermanos , Neoplasias Cutáneas/genética
10.
Braz J Biol ; 81(3): 665-673, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-32876171

RESUMEN

Educational interventions may trigger actions that contribute to prevent parasitic diseases, such as Chagas disease (CD). This study aimed at investigating the impact of an instructional video named "Documentary on Chagas Disease" on knowledge about CD and its vectors displayed by a population that lives in an endemic area in Brazil, so as to validate it as an educational tool. The video was shown to 226 subjects, divided into two groups. Group 1 was composed of users of Basic Health Units (BHU) in Pelotas and Pinheiro Machado, cities located in Rio Grande do Sul (RS) state, Brazil, where CD is endemic. Group 2 consisted of students who attend three public schools located in the rural area in Pinheiro Machado, RS. Two questionnaires with questions about their knowledge about triatomines and CD were applied, before and after the documentary was shown. After the video was shown, there was significant increase in individuals' knowledge (in both groups) about "kissing bugs", their notification, the disease and its prevention. Besides, watchers considered that the quality of the material was satisfactory. Since the "Documentary on CD" can be easily accessed on the internet and was effective in teaching the population that lives in endemic areas, its use should be encouraged in places and meetings connected to health that aim at fighting against triatominae and at exposing an updated view of CD.


Asunto(s)
Enfermedad de Chagas , Triatoma , Triatominae , Animales , Brasil/epidemiología , Enfermedad de Chagas/epidemiología , Humanos , Insectos Vectores
11.
Arq. bras. med. vet. zootec. (Online) ; 72(3): 719-728, May-June, 2020. tab
Artículo en Inglés | LILACS, VETINDEX | ID: biblio-1128887

RESUMEN

Este estudo investigou a toxicidade pré-natal do inseticida piriproxifeno em ratos Wistar, de forma a detectar possíveis alterações no desenvolvimento fetal da progênie exposta durante o período organogênico. Três doses de piriproxifeno (100, 300 e 500mg.kg-1) foram administradas por via oral às progenitoras, do sexto ao 15º dia de gestação. Os fetos foram submetidos à técnica de diafanização modificada descrita por Taylor e Van Dyke, para avaliação de malformações e alterações esqueléticas. Os resultados não demonstraram a ocorrência de toxicidade materna sistêmica ou alterações nos índices reprodutivos avaliados. Malformações ou alterações teratogênicas não foram detectadas, no entanto alterações esqueléticas sugestivas de retardo no desenvolvimento foram observadas especialmente nas doses mais altas testadas (300mg.kg-1 e 500mg.kg-1). Considerando-se a situação complexa de risco para a saúde humana, mostra-se importante a execução de investigações adicionais, de modo a contribuir para a adequada avaliação de risco do piriproxifeno em água potável.(AU)


This study investigated the prenatal toxicity of the insecticide pyriproxyfen in Wistar rats to detect the possible changes in the fetal development of the progeny exposed during the organogenic period. Three doses of pyriproxyfen (100, 300, and 500mg.kg-1) were administered orally to the progenitors, from day 6 to 15 of gestation. The fetuses were processed using the Taylor and Van Dyke modified diaphanization technique to evaluate malformations and skeletal changes. The results did not demonstrate the occurrence of systemic maternal toxicity or changes in the reproductive indexes evaluated. Malformations or teratogenic changes were not detected, however, skeletal changes suggestive of developmental delay were observed, especially in the highest doses tested (300 mg.kg-1 and 500 mg.kg-1). Owing to the potentially complex situation regarding its risk to human health, it is important that further studies be performed to contribute to the risk assessment of the addition of pyriproxyfen in drinking water.(AU)


Asunto(s)
Animales , Ratas , Plaguicidas/efectos adversos , Piridinas , Teratógenos/análisis , Desarrollo Fetal/efectos de los fármacos , Ratas Wistar/embriología , Virus Zika , Microcefalia/veterinaria
12.
Vaccine ; 37(36): 5137-5146, 2019 08 23.
Artículo en Inglés | MEDLINE | ID: mdl-31377079

RESUMEN

The first licensed dengue vaccine, CYD-TDV (Dengvaxia) is efficacious in seropositive individuals, but increases the risk for severe dengue in seronegative persons about two years after administration of the first dose. For countries considering the introduction of Dengvaxia, WHO recommends a pre-vaccination screening strategy whereby only persons with evidence of a past dengue infection would be vaccinated. Policy-makers need to consider the risk-benefit of vaccination strategies based on such screening tests, the optimal age to introduce the vaccine, communication and implementation strategies. To address these questions, the Global Dengue and Aedes-transmitted diseases Consortium (GDAC) organized a 3-day workshop in January 2019 with country representatives from Asia and Latin America. The meeting discussions highlighted many challenges in introducing Dengvaxia, in terms of screening test characteristics, costs of such tests combined with a 3-dose schedule, logistics, achieving high coverage rates, vaccine confidence and communication; more challenges than for any other vaccine introduction programme. A screening test would require a high specificity to minimize individual risk, and at the same time high sensitivity to maximize individual and population benefit. The underlying seroprevalence dependent positive predictive value is the best indicator for an acceptable safety profile of a pre-vaccination screening strategy. The working groups discussed many possible implementation strategies. Addressing the bottlenecks in school-based vaccine introduction for Dengvaxia will also benefit other vaccines such as HPV and booster doses for tetanus and pertussis. Levels of public trust are highly variable and context specific, and understanding of population perceptions and concerns is essential to tailor interventions, monitor and mitigate risks.


Asunto(s)
Vacunas contra el Dengue/uso terapéutico , Adolescente , Adulto , Anticuerpos Antivirales/inmunología , Niño , Dengue/inmunología , Dengue/microbiología , Dengue/prevención & control , Vacunas contra el Dengue/inmunología , Virus del Dengue , Humanos , Programas de Inmunización/métodos , Salud Pública , Estudios Seroepidemiológicos , Vacunas Atenuadas/uso terapéutico , Organización Mundial de la Salud , Adulto Joven
13.
G Chir ; 40(4): 322-324, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-32011985

RESUMEN

BACKGROUND: Groin hernioplasty is the most performed intervention in the adults worldwide. Small bowel occlusion after hernioplasty with anterior approach is an unusual complication because the peritoneum is not opened during this procedure. However during TAPP the closure of the peritoneal flap is mandatory. In literature some cases of small bowel occlusion related to the barbed suture for the closure the peritoneum are reported. METHODS: Here we describe a case of a 64-year old male with small bowel obstruction after TAPP caused by the barbed suture used for peritoneal closure. RESULTS: Intrabdominal use of self-anchoring suture is controversial. Some studies reported good results by using this device, while others from gynecologists describe bowel occlusion and volvulus caused by barbed suture. CONCLUSIONS: Self-anchoring device is innovative and reduces operation time. It is most important to know the correct use of this device to reduce some possible troubles.


Asunto(s)
Hernia Inguinal/cirugía , Herniorrafia/efectos adversos , Obstrucción Intestinal/etiología , Intestino Delgado , Complicaciones Posoperatorias/etiología , Técnicas de Sutura/instrumentación , Suturas/efectos adversos , Herniorrafia/métodos , Humanos , Obstrucción Intestinal/diagnóstico por imagen , Intestino Delgado/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/diagnóstico por imagen , Anclas para Sutura/efectos adversos , Técnicas de Sutura/efectos adversos
14.
G Chir ; 34(5): 309-314, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30444480

RESUMEN

BACKGROUND: Groin hernioplasty is most intervention performed in the worldwide. The present study aimed to evaluate a combination between ultralight mesh and fibrin human sealant in the laparoscopic treatment of inguinal hernia. PATIENTS AND METHODS: This retrospective study included consecutive patients who underwent laparoscopic transabdominal preperitoneal hernioplasty (TAPP) from 1st of January 2015 to 31st of December 2016. Demographics, surgical data and postoperative outcomes were entered in an anonymized prospective database. Prospective longterm follow-up carried out in all patients. RESULTS: One hundred eighty-four patients with a median age 57.5 (range 19-84) and median BMI (Body Mass Index) of 28.5 (range 18.5-31.5) were included. A median follow-up of 25 months (median 13-35) was carried out. Five recurrences (1.5%) and two cases of missed lipoma were observed and operated. Chronic pain (CP) was observed in eleven (9%) patients but in 9 patients it decreased spontaneously. CONCLUSIONS: Combination of ultralight mesh and Evicel® in TAPP operation is a safe solution for the treatment of groin hernia. Recurrences and chronic pain are similar to other combination of fibrin sealant and meshes. Moreover action of Evicel® may provide to improve the hemostasis and consequently hematoma of the cord.


Asunto(s)
Adhesivo de Tejido de Fibrina/uso terapéutico , Hernia Inguinal/cirugía , Herniorrafia/métodos , Laparoscopía/métodos , Adhesivos Tisulares/uso terapéutico , Adulto , Anciano , Anciano de 80 o más Años , Evaluación de Medicamentos , Femenino , Estudios de Seguimiento , Hematoma/etiología , Humanos , Masculino , Persona de Mediana Edad , Dolor Postoperatorio/etiología , Recurrencia , Estudios Retrospectivos , Mallas Quirúrgicas , Adulto Joven
15.
Eur J Neurol ; 25(10): 1270-1275, 2018 10.
Artículo en Inglés | MEDLINE | ID: mdl-29851435

RESUMEN

BACKGROUND AND PURPOSE: There is debate as to whether the apparent rebound after fingolimod discontinuation is related to the discontinuation itself or whether it is due to the natural course of highly active multiple sclerosis (MS). Our aim was to survey the prevalence of severe reactivation and rebound after discontinuation of fingolimod in a cohort of Italian patients with MS. METHODS: Patients with relapsing-remitting MS who were treated with fingolimod for at least 6 months and who stopped treatment for reasons that were unrelated to inefficacy were included in the analysis. RESULTS: A total of 100 patients who had discontinued fingolimod were included in the study. Fourteen patients (14%) had a relapse within 3 months after fingolimod discontinuation, and an additional 12 (12%) had a relapse within 6 months. According to this study's criteria, 10 patients (10%) had a severe reactivation. Amongst these patients, five (5%) had a reactivation that was considered to be a rebound. CONCLUSIONS: The present study showed that more than 26% of patients are at risk of having a relapse within 6 months after fingolimod discontinuation. Nevertheless, the risk of severe reactivations and rebound is lower than has been previously described.


Asunto(s)
Clorhidrato de Fingolimod/uso terapéutico , Inmunosupresores/uso terapéutico , Esclerosis Múltiple Recurrente-Remitente/tratamiento farmacológico , Adolescente , Adulto , Estudios de Cohortes , Femenino , Humanos , Italia , Imagen por Resonancia Magnética , Masculino , Esclerosis Múltiple Recurrente-Remitente/diagnóstico por imagen , Recurrencia , Privación de Tratamiento , Adulto Joven
16.
Braz. j. biol ; 77(2): 299-303, Apr.-June 2017. tab
Artículo en Inglés | LILACS | ID: biblio-888738

RESUMEN

Abstract The establishment and maintenance of plant species in the Chaco, one of the widest continuous areas of forests in the South American with sharp climatic variations, are possibly related to biological features favoring plants with particular defenses. This study assesses the physical and chemical defenses mechanisms against herbivores of vegetative and reproductive organs. Its analyses of 12 species of Fabaceae (Leguminosae) collected in remnants of Brazilian Chaco shows that 75% present structural defense characters and 50% have chemical defense - defense proteins in their seeds, like protease inhibitors and lectins. Physical defenses occur mainly on branches (78% of the species), leaves (67%), and reproductive organs (56%). The most common physical characters are trichomes and thorns, whose color represents a cryptic character since it does not contrast with the other plant structures. Defense proteins occur in different concentrations and molecular weight classes in the seeds of most species. Protease inhibitors are reported for the first time in seeds of: Albizia niopoides, Anadenanthera colubrina, Mimosa glutinosa, Prosopis rubriflora, and Poincianella pluviosa. The occurrence of physical and chemical defenses in members of Fabaceae indicate no associations between defense characters in these plant species of the Chaco.


Resumo O estabelecimento e a manutenção de espécies no Chaco, uma planície semi-árida da América do Sul com variações climáticas importantes, possivelmente estão relacionados a características biológicas que favorecem as plantas detentoras de defesas particulares. Este estudo teve como objetivos avaliar os mecanismos de defesa física e química anti-herbivoria em órgãos vegetativos e reprodutivos. Analisamos 12 espécies da família Fabaceae (Leguminosae) obtidas em remanescentes de Chaco brasileiro. Observamos que 75% das espécies estudadas apresentam atributo de defesa física e 50% possuem defesa química - proteínas de defesa nas sementes, como inibidores de protease e lectinas. As defesas físicas ocorrem principalmente nos ramos (78% das espécies), nos órgãos reprodutivos (56% das espécies) e nas folhas (67%). Os atributos físicos mais frequentes são tricomas e espinhos, cuja coloração não contrastante com as demais estruturas das plantas representa um caráter críptico. Proteínas de defesa ocorrem nas sementes da maioria das espécies, com diferentes concentrações e classes de pesos moleculares. Inibidores de protease nas sementes estão sendo relatados pela primeira vez em: Albizia niopoides, Anadenanthera colubrina, Mimosa glutinosa, Prosopis rubriflora e Poincianella pluviosa. A ocorrência de defesas física e química entre os membros de Fabaceae indica que não há associações entre as características de defesa das espécies de plantas avaliadas no Chaco.


Asunto(s)
Cadena Alimentaria , Fabaceae/anatomía & histología , Fabaceae/fisiología , Proteínas de Plantas/análisis , Semillas/química , Brasil , Herbivoria , Fabaceae/química
17.
Braz J Biol ; 77(2): 299-303, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-27599100

RESUMEN

The establishment and maintenance of plant species in the Chaco, one of the widest continuous areas of forests in the South American with sharp climatic variations, are possibly related to biological features favoring plants with particular defenses. This study assesses the physical and chemical defenses mechanisms against herbivores of vegetative and reproductive organs. Its analyses of 12 species of Fabaceae (Leguminosae) collected in remnants of Brazilian Chaco shows that 75% present structural defense characters and 50% have chemical defense - defense proteins in their seeds, like protease inhibitors and lectins. Physical defenses occur mainly on branches (78% of the species), leaves (67%), and reproductive organs (56%). The most common physical characters are trichomes and thorns, whose color represents a cryptic character since it does not contrast with the other plant structures. Defense proteins occur in different concentrations and molecular weight classes in the seeds of most species. Protease inhibitors are reported for the first time in seeds of: Albizia niopoides, Anadenanthera colubrina, Mimosa glutinosa, Prosopis rubriflora, and Poincianella pluviosa. The occurrence of physical and chemical defenses in members of Fabaceae indicate no associations between defense characters in these plant species of the Chaco.


Asunto(s)
Fabaceae/anatomía & histología , Fabaceae/fisiología , Cadena Alimentaria , Brasil , Fabaceae/química , Herbivoria , Proteínas de Plantas/análisis , Semillas/química
18.
Artículo en Inglés | LILACS-Express | LILACS, VETINDEX | ID: biblio-1467458

RESUMEN

Abstract Educational interventions may trigger actions that contribute to prevent parasitic diseases, such as Chagas disease (CD). This study aimed at investigating the impact of an instructional video named Documentary on Chagas Disease on knowledge about CD and its vectors displayed by a population that lives in an endemic area in Brazil, so as to validate it as an educational tool. The video was shown to 226 subjects, divided into two groups. Group 1 was composed of users of Basic Health Units (BHU) in Pelotas and Pinheiro Machado, cities located in Rio Grande do Sul (RS) state, Brazil, where CD is endemic. Group 2 consisted of students who attend three public schools located in the rural area in Pinheiro Machado, RS. Two questionnaires with questions about their knowledge about triatomines and CD were applied, before and after the documentary was shown. After the video was shown, there was significant increase in individuals knowledge (in both groups) about kissing bugs, their notification, the disease and its prevention. Besides, watchers considered that the quality of the material was satisfactory. Since the Documentary on CD can be easily accessed on the internet and was effective in teaching the population that lives in endemic areas, its use should be encouraged in places and meetings connected to health that aim at fighting against triatominae and at exposing an updated view of CD.


Resumo Intervenções educacionais podem desencadear ações que contribuam para a prevenção de doenças parasitárias, como a doença de Chagas (DC). Este estudo teve como objetivo investigar o impacto de um vídeo instrucional denominado Documentário Doença de Chagas no conhecimento sobre DC e seus vetores exibidos a uma população que vive em área endêmica no Brasil, para validá-lo como uma ferramenta educacional. O vídeo foi exibido para 226 indivíduos, divididos em dois grupos. O grupo 1 foi composto por usuários das Unidades Básicas de Saúde (UBS) de Pelotas e Pinheiro Machado, cidades do estado do Rio Grande do Sul (RS), Brasil, onde a DC é endêmica. O grupo 2 foi formado por estudantes que frequentam três escolas públicas localizadas na zona rural de Pinheiro Machado, RS. Dois questionários com perguntas sobre conhecimentos sobre triatomíneos e DC foram aplicados, antes e depois da exibição do documentário. Após a exibição do vídeo, houve um aumento significativo no conhecimento dos indivíduos (em ambos os grupos) sobre triatomíneos, sua notificação, a doença e sua prevenção. Além disso, os observadores consideraram que a qualidade do material era satisfatória. Como o Documentário DC pode ser facilmente acessado na Internet e ser eficaz no ensino à população que vive em áreas endêmicas, seu uso deve ser incentivado em locais e reuniões relacionadas à saúde, que visam combater os triatomíneos e exibir uma informação atualizada sobre a DC.

19.
Neuroscience ; 317: 130-40, 2016 Mar 11.
Artículo en Inglés | MEDLINE | ID: mdl-26762804

RESUMEN

Multiple sclerosis is a chronic, inflammatory and demyelinating disease of the central nervous system (CNS). As there is no cure for this disease, new therapeutic strategies and prophylactic measures are necessary. We recently described the therapeutic activity of the association between myelin oligodendrocyte glycoprotein peptide (MOG) and active vitamin D3 (VitD) against experimental autoimmune encephalomyelitis (EAE). The objective of this work was to evaluate the prophylactic potential of this association in EAE. C57BL/6 mice were vaccinated with MOG in the presence of VitD and then subjected to EAE induction. Animals were euthanized 7 and 19days after disease induction and the following parameters were evaluated: body weight, clinical score, inflammatory process in the CNS, amount of dendritic cells (DCs) and regulatory T cells in the spleen and cytokine production by spleen and CNS cell cultures. Vaccination with MOG associated with VitD determined a drastic reduction in clinical score, body weight loss, CNS inflammation, DCs maturation and also in the production of cytokines by CNS and spleen cell cultures. Collectively, our data indicate that this association prevents EAE development. A similar effect from specific self-antigens associated with VitD is expected in other autoimmune conditions and deserves to be experimentally appraised.


Asunto(s)
Sistema Nervioso Central/patología , Encefalomielitis Autoinmune Experimental/prevención & control , Glicoproteína Mielina-Oligodendrócito/toxicidad , Vitamina D/administración & dosificación , Vitaminas/administración & dosificación , Animales , Células Cultivadas , Citocinas/metabolismo , Modelos Animales de Enfermedad , Relación Dosis-Respuesta a Droga , Relación Dosis-Respuesta Inmunológica , Esquema de Medicación , Encefalomielitis Autoinmune Experimental/inducido químicamente , Encefalomielitis Autoinmune Experimental/patología , Femenino , Citometría de Flujo , Adyuvante de Freund/toxicidad , Ratones , Ratones Endogámicos C57BL , Glicoproteína Mielina-Oligodendrócito/inmunología , Neuronas/metabolismo , Bazo/patología , Factores de Tiempo
20.
Nanoscale ; 8(4): 2212-8, 2016 Jan 28.
Artículo en Inglés | MEDLINE | ID: mdl-26734853

RESUMEN

A thin film of heavily B-doped diamond has been grown epitaxially by microwave plasma chemical vapor deposition on an undoped diamond layer, on top of a Ir/YSZ/Si(001) substrate stack, to study the boron segregation and boron environment at the dislocations present in the film. The density and nature of the dislocations were investigated by conventional and weak-beam dark-field transmission electron microscopy techniques, revealing the presence of two types of dislocations: edge and mixed-type 45° dislocations. The presence and distribution of B in the sample was studied using annular dark-field scanning transmission electron microscopy and spatially resolved electron energy-loss spectroscopy. Using these techniques, a segregation of B at the dislocations in the film is evidenced, which is shown to be intermittent along the dislocation. A single edge-type dislocation was selected to study the distribution of the boron surrounding the dislocation core. By imaging this defect at atomic resolution, the boron is revealed to segregate towards the tensile strain field surrounding the edge-type dislocations. An investigation of the fine structure of the B-K edge at the dislocation core shows that the boron is partially substitutionally incorporated into the diamond lattice and partially present in a lower coordination (sp(2)-like hybridization).

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