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Nowadays, the gold standard for the surgical treatment of abdominal wall defects is the use of a mesh. There is an extensive variety of meshes, self-adhesive ones being among the most novel technologies. The literature on the self-adhesive mesh Adhesix® (Cousin Biotech Laboratory, 59117 Wervicq South, France) in medial incisional ventral hernia is scarce. We performed a retrospective descriptive study with prospective data collection from 125 patients who underwent prosthetic repair of medial incisional ventral hernia-M1-M5 classification according to European Hernia Society (EHS)-with self-adhesive mesh Adhesix® between 2013 and 2021. Follow-up was performed 1 month and yearly after the surgery. Postoperative complications and hernia recurrences were recorded. Epidemiological results were average BMI 30.5 kg/m2 (SD 5), highlighting that overweight (41.6%) and obesity type 1 (25.6%) were the most represented groups. 34 patients (27.2%) had already undergone a previous abdominal wall surgery. The epigastric-umbilical (M2-M3 EHS classification, 22.4%) and umbilical (M3 EHS classification, 20%) hernias were the predominant groups. The elective surgery technique was Rives or Rives-Stoppa with an associated supraaponeurotic mesh if the closure of the anterior aponeurosis of the rectus sheath was not surgically closed (13 patients). The most frequent postoperative complication was seroma (26.4%). The recurrence rate was 7.2%. The average follow-up length was 2.6 years (SD 1.6 years). According to the results of this study and the literature available, we consider that the self-adhesive mesh Adhesix® is an appropriate alternative mesh option for the repair of medial incisional ventral hernias.
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Hérnia Ventral , Hérnia Incisional , Humanos , Telas Cirúrgicas/efeitos adversos , Estudos Retrospectivos , Cimentos de Resina , Herniorrafia/efeitos adversos , Herniorrafia/métodos , Hérnia Ventral/cirurgia , Hérnia Ventral/etiologia , Hérnia Incisional/etiologia , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/cirurgia , RecidivaRESUMO
This article seeks to provide a snapshot of the security of Wi-Fi access points in the metropolitan area of A Coruña. First, we discuss the options for obtaining a tool that allows the collection and storage of auditable information from Wi-Fi networks, from location to signal strength, security protocol or the list of connected clients. Subsequently, an analysis is carried out aimed at identifying password patterns in Wi-Fi networks with WEP, WPA and WPA2 security protocols. For this purpose, a password recovery tool called Hashcat was used to execute dictionary or brute force attacks, among others, with various word collections. The coverage of the access points in which passwords were decrypted is displayed on a heat map that represents various levels of signal quality depending on the signal strength. From the handshakes obtained, and by means of brute force, we will try to crack as many passwords as possible in order to create a targeted and contextualized dictionary both by geographical location and by the nature of the owner of the access point. Finally, we will propose a contextualized grammar that minimizes the size of the dictionary with respect to the most used ones and unifies the decryption capacity of the combination of all of them.
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OBJECTIVE: To evaluate the results of bloc resection and vascular reconstruction of leiomyosarcomas with involvement of main vessels in the lower extremities. MATERIAL AND METHODS: From January 1983 to December 2016, 42 patients with leiomyosarcomas were diagnosed. Six of these leiomyosarcomas affected main vessels of the lower extremities (called vascular). Epidemiological data, imaging studies, surgery performed, adjuvant treatments, complications, as well as recurrences and mortality were retrospectively recorded. RESULTS: All the patients were affected by high-grade leiomyosarcomas (ii-iii FNCLCC classification), with a larger tumour average diameter of 9.1cm(6-15) and a mean follow-up of 23 months (7-36). The average age was 64 years (29-84). The first symptom was a palpable tumour in 4 of them. The other 2 cases debuted with thromboembolic phenomena. In 5 cases the origin was the femoral vessels, while one case was at the popliteal level. Although all cases preserved the limb, in 3 cases (50%) they presented pulmonary dissemination,2 cases (33%) hepatic dissemination and one case had local recurrence. Two cases died at the end of the study and there was one case of loss to follow-up. DISCUSSION AND CONCLUSIONS: Vascular leiomyosarcomas are highly aggressive tumours with a low survival rate at 5 years. In our study, 50% of the patients remain in complete remission with a mean follow-up of 23 months. Their onset frequently associates the presence of tumour mass with thrombotic phenomena (33% of our cases). Tumour resection surgery usually compromises the main vascular structures, which implies resection and vascular reconstructive techniques to salvage the limb.
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Leiomiossarcoma/cirurgia , Extremidade Inferior/irrigação sanguínea , Neoplasias Vasculares/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Leiomiossarcoma/mortalidade , Extremidade Inferior/cirurgia , Masculino , Pessoa de Meia-Idade , Procedimentos de Cirurgia Plástica , Estudos Retrospectivos , Análise de Sobrevida , Resultado do Tratamento , Neoplasias Vasculares/mortalidade , Procedimentos Cirúrgicos VascularesRESUMO
Cross-modal reorganization in the auditory and visual cortices has been reported after hearing and visual deficits mostly during the developmental period, possibly underlying sensory compensation mechanisms. However, there are very few data on the existence or nature and timeline of such reorganization events during sensory deficits in adulthood. In this study, we assessed long-term changes in activity-dependent immediate early genes c-Fos and Arc/Arg3.1 in auditory and neighboring visual cortical areas after bilateral deafness in young adult rats. Specifically, we analyzed qualitatively and quantitatively c-Fos and Arc/Arg3.1 immunoreactivity at 15 and 90 days after cochlea removal. We report extensive, global loss of c-Fos and Arc/Arg3.1 immunoreactive neurons in the auditory cortex 15 days after permanent auditory deprivation in adult rats, which is partly reversed 90 days after deafness. Simultaneously, the number and labeling intensity of c-Fos- and Arc/Arg3.1-immunoreactive neurons progressively increase in neighboring visual cortical areas from 2 weeks after deafness and these changes stabilize three months after inducing the cochlear lesion. These findings support plastic, compensatory, long-term changes in activity in the auditory and visual cortices after auditory deprivation in the adult rats. Further studies may clarify whether those changes result in perceptual potentiation of visual drives on auditory regions of the adult cortex.
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Córtex Auditivo/metabolismo , Proteínas do Citoesqueleto/metabolismo , Regulação da Expressão Gênica/fisiologia , Perda Auditiva/patologia , Proteínas do Tecido Nervoso/metabolismo , Proteínas Proto-Oncogênicas c-fos/metabolismo , Córtex Visual/metabolismo , Animais , Vias Auditivas/metabolismo , Cóclea/lesões , Cóclea/metabolismo , Cóclea/patologia , Modelos Animais de Doenças , Potenciais Evocados Auditivos , Perda Auditiva/metabolismo , Masculino , Ratos , Ratos Wistar , Gânglio Espiral da Cóclea/patologiaRESUMO
Introducción: Las alteraciones en el habla aparecen en la mayoría de los pacientes con la enfermedad de Parkinson (EP) en el curso del trastorno. Su origen y gravedad son de interés clínico y diagnóstico. Objetivo: Evaluar los patrones de deterioro en el habla en pacientes con la EP, e identificar diferencias en la velocidad de elocución y articulación en comparación con sujetos de control, empleando un método de análisis automático en una tarea de lectura. Pacientes: Participaron 39 pacientes con la EP y 45 controles asintomáticos igualados en sexo y edad. Los pacientes con la EP, en estado on, no presentaban fluctuaciones motoras ni discinesias durante la evaluación del habla. Resultados: El grupo de pacientes con la EP muestran una significativa reducción de la velocidad de elocución y articulación. No se encontraron correlaciones significativas entre los parámetros del habla estudiados y las características de los pacientes, tales como la dosis de L-dopa, duración del trastorno, edad, ni en las puntuaciones en las escalas UPDRS III o Hoehn y Yahr. Conclusiones: Los pacientes con la EP muestran un patrón característico de deterioro del ritmo del habla. Estos resultados indican que las disfluencias en la EP son el resultado de la alteración del movimiento que afecta a la fisiología de los sistemas de producción del habla
Introduction: Speech disturbances will affect most patients with Parkinson's disease (PD) over the course of the disease. The origin and severity of these symptoms are of clinical and diagnostic interest. Purpose: To evaluate the clinical pattern of speech impairment in PD patients and identify significant differences in speech rate and articulation compared to control subjects. Speech rate and articulation in a reading task were measured using an automatic analytical method. Patients: A total of 39 PD patients in the on state and 45 age-and sex-matched asymptomatic controls participated in the study. None of the patients experienced dyskinesias or motor fluctuations during the test. Results: The patients with PD displayed a significant reduction in speech and articulation rates; there were no significant correlations between the studied speech parameters and patient characteristics such as L-dopa dose, duration of the disorder, age, and UPDRS III scores and Hoehn & Yahr scales. Conclusion: atients with PD show a characteristic pattern of declining speech rate. These results suggest that in PD, disfluencies are the result of the movement disorder affecting the physiology of speech production systems
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Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Doença de Parkinson/complicações , Doença de Parkinson/terapia , Transtornos da Articulação/complicações , Transtornos da Articulação/diagnóstico , Transtornos da Articulação/terapia , Audiometria da Fala/métodos , Transtornos do Desenvolvimento da Linguagem/terapia , Levodopa/análise , Levodopa/uso terapêutico , Disartria/complicações , Fala/fisiologia , Testes de Articulação da Fala/instrumentação , Testes de Articulação da Fala/métodos , Testes de Articulação da Fala , Distúrbios da Fala/diagnóstico , Distúrbios da Fala/terapia , Estudos Transversais/métodos , Estudos Retrospectivos , Análise de Dados/métodosRESUMO
INTRODUCTION: Speech disturbances will affect most patients with Parkinson's disease (PD) over the course of the disease. The origin and severity of these symptoms are of clinical and diagnostic interest. PURPOSE: To evaluate the clinical pattern of speech impairment in PD patients and identify significant differences in speech rate and articulation compared to control subjects. Speech rate and articulation in a reading task were measured using an automatic analytical method. PATIENTS: A total of 39 PD patients in the 'on' state and 45 age-and sex-matched asymptomatic controls participated in the study. None of the patients experienced dyskinesias or motor fluctuations during the test. RESULTS: The patients with PD displayed a significant reduction in speech and articulation rates; there were no significant correlations between the studied speech parameters and patient characteristics such as L-dopa dose, duration of the disorder, age, and UPDRS III scores and Hoehn & Yahr scales. CONCLUSION: Patients with PD show a characteristic pattern of declining speech rate. These results suggest that in PD, disfluencies are the result of the movement disorder affecting the physiology of speech production systems.
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Doença de Parkinson/psicologia , Fala , Adulto , Idoso , Antiparkinsonianos/efeitos adversos , Antiparkinsonianos/uso terapêutico , Transtornos da Articulação/etiologia , Transtornos da Articulação/psicologia , Progressão da Doença , Feminino , Humanos , Levodopa/efeitos adversos , Levodopa/uso terapêutico , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Doença de Parkinson/tratamento farmacológicoRESUMO
Introducción: Numerosos estudios han puesto de manifiesto que la alteración en la capacidad comunicativa es uno de los síntomas característicos de la enfermedad de Alzheimer (EA). Objetivo: Estudiar la organización temporal del habla en una tarea de lectura en un grupo de pacientes con EA y otro de controles sanos, utilizando un procedimiento semiautomático, así como valorar su capacidad para discriminar entre ambos grupos. Sujetos y método: Se aplicó una prueba de lectura a 70 sujetos: 35 con EA y otros tantos controles. Antes del registro del habla, los sujetos fueron sometidos a una batería de pruebas neuropsicológicas. Los grupos no diferían en edad, sexo o nivel de estudios. Resultados: Todas las variables analizadas se mostraron alteradas en el grupo con EA. Los resultados señalan que la lectura de los pacientes con EA se caracteriza por una reducida velocidad de elocución y articulación, una baja efectividad del tiempo de fonación, así como en un incremento del número y la proporción de las pausas. Los algoritmos de procesamiento de la señal aplicados a las grabaciones de fluidez lectora demostraron su capacidad para discriminar entre ambos grupos con una precisión del 80% (especificidad 74,2%; sensibilidad 77,1%) mediante la velocidad de elocución. Conclusión: El análisis de la fluidez de lectura oral puede representar una herramienta potencial para el análisis objetivo y la cuantificación de los déficits del lenguaje en la EA (AU)
Introduction: Many studies highlight that an impaired ability to communicate is one of the key clinical features of Alzheimer disease (AD). Objective: To study temporal organisation of speech in an oral reading task in patients with AD and in matched healthy controls using a semi-automatic method, and evaluate that method's ability to discriminate between the 2 groups. Subjects and methods: A test with an oral reading task was administered to 70 subjects, comprising 35 AD patients and 35 controls. Before speech samples were recorded, participants completed a battery of neuropsychological tests. There were no differences between groups with regard to age, sex, or educational level. Results: All of the study variables showed impairment in the AD group. According to the results, AD patients oral reading was marked by reduced speech and articulation rates, low effectiveness of phonation time, and increases in the number and proportion of pauses. Signal processing algorithms applied to reading fluency recordings were shown to be capable of differentiating between AD patients and controls with an accuracy of 80% (specificity 74.2%, sensitivity 77.1%) based on speech rate. Conclusion: Analysis of oral reading fluency may be useful as a tool for the objective study and quantification of speech deficits in AD (AU)
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Humanos , Doença de Alzheimer/fisiopatologia , Leitura , Transtornos Cognitivos/fisiopatologia , Distúrbios da Fala/epidemiologia , Transtornos da Articulação/epidemiologiaRESUMO
In the present work we analyzed the effect of the chronic administration of risperidone (2mg/kg over 65 days) on behavioural, morphological and molecular aspects in an experimental model of schizophrenia obtained by bilateral injection of ibotenic acid into the ventral hippocampus of new-born rats. Our results show that during their adult lives the animals with hippocampal lesions exhibit different alterations, mainly at behavioural level and in the gene expression of dopamine D(2) and 5-HT(2A) receptors. However, at morphological level the study performed on the prefrontal cortex did not reveal any alterations in either the thickness or the number of cells immunoreactive for c-Fos, GFAP, CBP or PV. Overall, risperidone administration elicited a trend towards the recovery of the values previously altered by the hippocampal lesion, approaching the values seen in the animals without lesions. It may be concluded that the administration of risperidone in the schizophrenia model employed helps to improve the altered functions, with no significant negative effects.
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Antipsicóticos/administração & dosagem , Comportamento Animal/efeitos dos fármacos , Encéfalo/patologia , Regulação da Expressão Gênica/efeitos dos fármacos , Risperidona/administração & dosagem , Esquizofrenia/tratamento farmacológico , Fatores Etários , Animais , Animais Recém-Nascidos , Aprendizagem da Esquiva/efeitos dos fármacos , Aprendizagem da Esquiva/fisiologia , Encéfalo/metabolismo , Proteína de Ligação a CREB/metabolismo , Contagem de Células , Modelos Animais de Doenças , Esquema de Medicação , Agonistas de Aminoácidos Excitatórios/toxicidade , Comportamento Exploratório/efeitos dos fármacos , Comportamento Exploratório/fisiologia , Feminino , Proteína Glial Fibrilar Ácida/metabolismo , Asseio Animal/efeitos dos fármacos , Hipocampo/efeitos dos fármacos , Hipocampo/fisiologia , Ácido Ibotênico/toxicidade , Masculino , Parvalbuminas/metabolismo , Proteínas Proto-Oncogênicas c-fos/metabolismo , Ratos , Ratos Wistar , Receptor 5-HT2A de Serotonina/genética , Receptor 5-HT2A de Serotonina/metabolismo , Receptores de Dopamina D2/genética , Receptores de Dopamina D2/metabolismo , Esquizofrenia/induzido quimicamente , Esquizofrenia/fisiopatologiaRESUMO
INTRODUCTION: Many studies highlight that an impaired ability to communicate is one of the key clinical features of Alzheimer disease (AD). OBJECTIVE: To study temporal organisation of speech in an oral reading task in patients with AD and in matched healthy controls using a semi-automatic method, and evaluate that method's ability to discriminate between the 2 groups. SUBJECTS AND METHODS: A test with an oral reading task was administered to 70 subjects, comprising 35 AD patients and 35 controls. Before speech samples were recorded, participants completed a battery of neuropsychological tests. There were no differences between groups with regard to age, sex, or educational level. RESULTS: All of the study variables showed impairment in the AD group. According to the results, AD patients' oral reading was marked by reduced speech and articulation rates, low effectiveness of phonation time, and increases in the number and proportion of pauses. Signal processing algorithms applied to reading fluency recordings were shown to be capable of differentiating between AD patients and controls with an accuracy of 80% (specificity 74.2%, sensitivity 77.1%) based on speech rate. CONCLUSION: Analysis of oral reading fluency may be useful as a tool for the objective study and quantification of speech deficits in AD.
Assuntos
Doença de Alzheimer/fisiopatologia , Leitura , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Estudos Retrospectivos , FalaRESUMO
Objetivo. El objetivo principal de este estudio es comprobar la inocuidad del marcaje de células madre mesenquimales derivadas de tejido adiposo con partículas de hierro superparamagnético (SPIO) en términos de proliferación y multipotencialidad celular. El objetivo final es posibilitar el seguimiento celular in vivo mediante resonancia magnética con vistas a una posible aplicación en técnicas de terapia celular e ingeniería tisular en el área de la Cirugía Ortopédica y Traumatología. Método. Mediante protocolos estandarizados se aislaron y cultivaron células mesenquimales procedentes de 10 muestras de tejido graso. En pases 1P y 2P, dichas células fueron marcadas con SPIO, empleando sulfato de protamina como agente transfectante. Tras comprobar la eficiencia del marcaje mediante tinción con azul de Prusia, se analizó el efecto del mismo sobre el crecimiento y la multipotencialidad de las poblaciones celulares mediante el estudio de su crecimiento in vitro y su capacidad de diferenciación hacia diferentes estirpes celulares. Finalmente, se estudió la posibilidad de localizar las poblaciones celulares marcadas mediante resonancia magnética de 3 Teslas. Resultados y conclusión. Las poblaciones celulares aisladas a partir de las muestras de grasa subcutánea marcadas con SPIO, muestran patrones de crecimiento y multipotencialidad similares a las poblaciones control. Dichas células son visibles mediante imagen por resonancia magnética una vez implantadas en una pieza ósea de control. Los resultados obtenidos en este estudio indican que esta metodología podría aplicarse a la monitorización de las células implantadas en defectos óseos (AU)
Objective. The aim of this study was to study the viability and multipotential capacity of adipose derived mesenchymal stem cells, after being labelled with superparamagnetic iron oxide particles. The final aim is to monitor stem cells after being implanted by cellular therapy and tissue engineering techniques in the field of Orthopaedics and Traumatology. Method. Ten biopsies of adipose tissue were processed in order to isolate adipose derived mesenchymal stem cells, which were cultured under standard in vitro culture conditions until pre-confluent state. Cells in 1P and 2P were labelled with superparamagnetic iron oxide particles (SPIO), using protamine sulphate as a transfection agent. After confirming labelling efficiency with Prussian blue staining, we studied the labelling effect on the growth and multipotency of stem cells by analysing their in vitro growth curves and their capacity to differentiate into adipogenic, osteogenic and chondrogenic cell lines. We also tried to view the labelled stem cells using 3 Tesla magnetic resonance imaging. Results and conclusion. Adipose derived stem cells labelled with SPIO showed a proliferation and differentiation capacity similar to control stem cells. These cells were visible on MR images after been implanted in a bone piece. Therefore, in vitro cell labelling of adipose derived mesenchymal stem cells with SPIO could be useful for in vivo cell tracking by MRI in bone tissue engineering (AU)
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Humanos , Masculino , Feminino , Células-Tronco Mesenquimais/metabolismo , Células-Tronco Mesenquimais , Terapia Baseada em Transplante de Células e Tecidos/instrumentação , Terapia Baseada em Transplante de Células e Tecidos/métodos , Ortopedia/métodos , Ortopedia/tendências , Protaminas , Imageamento por Ressonância Magnética/métodos , Imageamento por Ressonância Magnética , Protocolos ClínicosRESUMO
Taking into account that most of the experimental research into the effects of antipsychotic drugs has mainly focused on behavioural aspects, the aim of the present work is to investigate the effects of a chronic therapeutic dose of risperidone (1 mg/kg/day during 140 days) on both behavioural and morphological aspects in healthy rats. The behavioural results revealed only minor modifications in prepulse inhibition, showing the risperidone-treated group higher values at 70 days of treatment with respect to the vehicle group. Moreover, in the open-field test, this group showed a greater incidence of grooming. In the active avoidance test, no differences were found between the groups studied. Additionally, in the morphological study performed to analyse cortical thickness and the number of GFAP-, CaBP-, PV- and Fos-immunostained cells no differences were seen between the two groups studied. It is important to note that the risperidone-treated group showed a slight increase in the total number of cells counted, although this increase was not significant. Our results indicate that the chronic administration of therapeutic doses of risperidone does not produce any dramatic behavioural or morphological changes in healthy animals.
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Antipsicóticos/farmacologia , Comportamento Animal/efeitos dos fármacos , Encéfalo/efeitos dos fármacos , Neurônios/efeitos dos fármacos , Risperidona/farmacologia , Animais , Percepção Auditiva/efeitos dos fármacos , Aprendizagem da Esquiva/efeitos dos fármacos , Encéfalo/anatomia & histologia , Encéfalo/metabolismo , Calbindinas , Contagem de Células , Proteína Glial Fibrilar Ácida/metabolismo , Asseio Animal/efeitos dos fármacos , Masculino , Neurônios/citologia , Neurônios/metabolismo , Tamanho do Órgão , Parvalbuminas/metabolismo , Proteínas Proto-Oncogênicas c-fos/metabolismo , Distribuição Aleatória , Ratos , Ratos Wistar , Reflexo de Sobressalto/efeitos dos fármacos , Proteína G de Ligação ao Cálcio S100/metabolismoRESUMO
Introducción. Desde que Parodi colocó la primera endoprótesis (EP) en 1991, la terapéutica endovascular ha tenido una evolución creciente y su utilización forma parte de la práctica quirúrgica diaria. Con el paso del tiempo han surgido nuevas complicaciones cuya resolución no siempre está consensuada. Caso clínico. Varón de 74 años con alto riesgo quirúrgico que fue tratado con una EP de tipo Vanguard bifurcada por un aneurisma de aorta abdominal. El postoperatorio cursó sin complicaciones. En la radiografía de abdomen a los seis meses se observó una rotura de la sutura proximal; la tomografía computarizada (TC) no informó de complicaciones. A los dos años, la TC mostraba una fuga de contraste en las ramas, aunque se mantenía el diámetro del saco. Medio año después, el tamaño del aneurisma había crecido 1 cm. La angiografía por sustracción digital mostró una fuga de tipo II que requirió la embolización con coils. En los controles posteriores, la TC demostró la disminución del aneurisma y las radiografías evidenciaron una progresiva angulación y elongación de la EP. A los seis años y medio de la colocación de la EP, el paciente acudió a urgencias por un dolor lumbar e hipertensión. En la TC de urgencias se observaba una migración de la EP con extravasación de contraste en el saco sin sangrado retroperitoneal. El paciente fue intervenido y se encontró una extracción de la EP dificultosa. Finalmente falleció por shock hemorrágico
Introduction. Since the first stent was placed by Parodi in 1991, endovascular therapy has continued to develop and grow and it is now commonly used in daily surgical practice. As time goes by new complications have arisen and specialists do not always agree on how to resolve them. Case report. Our study involved the case of a 74-years-old male with a high surgical risk who was treated for an abdominal aortic aneurysm by means of a bifurcated Vanguard-type stent. No complications occurred during the post-operative period. An X-ray of the abdomen taken at six months revealed breakage of the proximal suture; a computerised tomography (CT) scan did not show any complications. At two years, the CT showed a contrast leak in the branches, although the diameter of the sac was preserved. Half a year later, the aneurysm had grown 1 cm. Digital subtraction angiography showed a type II leak that required coil embolisation. In later revisions, the CT scan showed that the aneurysm had got smaller and x-rays evidenced a progressive kinking and lengthening of the stent. Six and a half years after placement of the stent, the patient visited the emergency department because of lower back pain and high blood pressure. The emergency CT scan revealed migration of the stent with contrast extravasation in the sac and no retroperitoneal bleeding. The patient was submitted to a surgical intervention and extraction of the stent was found to be a complicated procedure. The patient finally died due to haemorrhagic shock
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Masculino , Pessoa de Meia-Idade , Humanos , Aneurisma da Aorta Abdominal/complicações , Aneurisma da Aorta Abdominal/cirurgia , Ruptura Aórtica/diagnóstico , Radiografia Abdominal , Tomografia Computadorizada de Emissão/métodos , Angiografia/métodos , Laparotomia/métodos , Choque Hemorrágico/complicações , Choque Hemorrágico/mortalidade , Aorta Abdominal/fisiopatologia , Aorta Abdominal/cirurgia , Aorta AbdominalAssuntos
Adenoma/diagnóstico , Neoplasias do Colo/diagnóstico , Neoplasias Retais/diagnóstico , Desequilíbrio Hidroeletrolítico/diagnóstico , Adenoma/complicações , Idoso de 80 Anos ou mais , Neoplasias do Colo/complicações , Diarreia/etiologia , Humanos , Masculino , Neoplasias Retais/complicações , Insuficiência Renal/complicações , Síndrome , Desequilíbrio Hidroeletrolítico/complicaçõesRESUMO
No disponible
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Masculino , Idoso de 80 Anos ou mais , Humanos , Adenoma/diagnóstico , Desequilíbrio Hidroeletrolítico/diagnóstico , Neoplasias do Colo/diagnóstico , Neoplasias Retais/diagnóstico , Adenoma/complicações , Diarreia/etiologia , Síndrome , Desequilíbrio Hidroeletrolítico/complicações , Neoplasias do Colo/complicações , Neoplasias Retais/complicaçõesRESUMO
Objetivo. Realizar una revisión de la literatura referente al tratamiento de la ruptura de la aorta torácica de etiología no traumática y la valoración de los resultados del tratamiento endovascular. Desarrollo. La ruptura de la aorta, independientemente de su localización, es una patología extremadamente grave. La ruptura aórtica se asocia con el hematoma mediastínico, el hemotórax y la fístula aortobronquial o aortoesofágica. La cirugía abierta continúa teniendo una mortalidad significativamente elevada y posiblemente no asumible, por lo que la conducta actual, cuando las condiciones anatómicas lo permiten, suele ser decantarse por el tratamiento endovascular; sin embargo, el beneficio de el tratamiento endovascular urgente permanece incierto. Las endoprótesis aórticas se han usado para tratar los aneurismas de aorta torácica en pacientes de alto riesgo, incluidos aquellos que presentaban una fístula aortobronquial o aortoesofágica. Conclusiones. Si no se trata, la ruptura de la aorta torácica es una situación mortal, los resultados de la cirugía abierta son desalentadores y la morbilidad de los supervivientes elevada. A pesar de que la terapia endovascular consigue una reducción significativa de la morbimortalidad, la información actual se basa en series cortas o casos aislados, por lo que es necesario completar los registros actuales para poder confirmar las expectativas generadas
Aim. To review the literature concerning the treatment of rupture of the thoracic aorta due to non-traumatic causes and to evaluate the outcomes of endovascular treatment. Development. Rupture of the aorta, regardless of where it happens, is an extremely severe condition. Aortic rupture is associated with mediastinal haematoma, haemothorax and aortobronchial or aortoesophageal fistula. Open surgery continues to have a significantly, and possibly unacceptably, high mortality rate and therefore the current behaviour (anatomical conditions allowing) is usually to opt for endovascular treatment. The benefits of urgent endovascular treatment, however, remain uncertain. Aortic stents have been used to treat thoracic aortic aneurysms in high risk patients, including those who have an aortobronchial or an aortoesophageal fistula. Conclusions. If left untreated, rupture of the thoracic aorta is a fatal situation, outcomes of open surgery are disappointing and morbidity among survivors is high. Despite the fact that endovascular therapy achieves a significant reduction in morbidity and mortality rates, the information currently available is based on short series or isolated cases, and therefore present records must be completed in order to confirm the expectations that have been generated
Assuntos
Ruptura Aórtica/diagnóstico , Ruptura Aórtica/etiologia , Ruptura Aórtica/terapia , Aneurisma Aórtico/diagnóstico , Aneurisma Aórtico/cirurgia , Fístula/terapia , Tomografia Computadorizada de Emissão/métodos , Fístula Vascular/diagnóstico , Fístula Vascular/terapiaRESUMO
Encapsulation of the model protein bovine serum albumin (BSA) into poly(D,L lactide-co-glycolide) (PLG) microspheres was performed by a non-aqueous oil-in-oil (o/o) methodology. Powder formulations of BSA obtained by spray-freeze drying were first suspended in methylene chloride containing PLG followed by coacervation by adding silicon oil and microsphere hardening in heptane. The secondary structure of BSA was determined at relevant steps of the encapsulation procedure by employing Fourier-transform infrared (FTIR) spectroscopy. This fast and non-invasive method demonstrated the potential to rapidly screen pharmaceutically relevant protein delivery systems for their suitability. Structural perturbations in BSA were reduced during the spray-freeze drying step by employing the excipient trehalose. The protein was then encapsulated into PLG microspheres under various conditions without inducing significant structural perturbations. BSA released from these microspheres had a similar monomer content as unencapsulated BSA and also the same secondary structure. Upon blending of a poloxamer (Pluronic F-68) with the polymer phase, in vitro release was characterized by a small initial release and a prolonged and continuous sustained phase. In conclusion, the developed o/o methodology coupled with FTIR spectroscopic monitoring of protein structure is a powerful approach for the development of sustained release microspheres.
Assuntos
Sistemas de Liberação de Medicamentos , Ácido Láctico , Ácido Poliglicólico , Polímeros , Soroalbumina Bovina/administração & dosagem , Cromatografia Líquida de Alta Pressão , Dicroísmo Circular , Portadores de Fármacos , Composição de Medicamentos , Liofilização , Microesferas , Copolímero de Ácido Poliláctico e Ácido Poliglicólico , Solubilidade , Espectrofotometria Ultravioleta , Espectroscopia de Infravermelho com Transformada de FourierRESUMO
Protein stability is a factor limiting the use of sustained-release devices in medical applications. The aim of this study was to reduce structural perturbations occurring in the frequently used model protein, bovine serum albumin (BSA), upon microencapsulation in poly(D,L-lactide-co-glycolide) (PLG) microspheres. Spray freeze-dried BSA was encapsulated into PLG microspheres by a completely non-aqueous oil-in-oil encapsulation procedure. FTIR spectroscopy was used as a non-invasive method to quantify procedure-induced structural perturbations in BSA. Spray-freeze drying of BSA caused significant structural perturbations that were minimized by co-spray freeze-drying BSA with trehalose. BSA-containing microspheres were produced by suspension of the powder by homogenization in methylene chloride containing PLG, followed by formation of coacervate droplets by the addition of silicon oil and hardening using the solvent heptane. Resulting microspheres had dimensions of approximately 100 microm and the encapsulation efficiency for BSA was > 90%. FTIR data showed that the structure of the BSA-trehalose formulation encapsulated into PLG microspheres was less perturbed than that of BSA obtained from buffer alone. The results demonstrate that the structure-guided encapsulation approach introduced for non-aqueous casting encapsulation procedures can be extended to the non-aqueous production of pharmaceutically relevant PLG microspheres involving a complex encapsulation procedure.
Assuntos
Soroalbumina Bovina/farmacocinética , Materiais Biocompatíveis , Composição de Medicamentos , Liofilização , Ácido Láctico , Microesferas , Ácido Poliglicólico , Copolímero de Ácido Poliláctico e Ácido Poliglicólico , Polímeros , Soroalbumina Bovina/administração & dosagem , Espectroscopia de Infravermelho com Transformada de Fourier , Relação Estrutura-AtividadeRESUMO
We report a case of actinomycosis with uncommon localizations that was due to Actinomyces meyeri. Although penicillin is the standard treatment for this condition, our patient was treated successfully with imipenem. Actinomyces organisms are important constituents of the normal flora of mucous membranes and are considered opportunistic pathogens; these organisms may produce infection after local trauma, surgery, or aspiration. The mains forms of actinomycosis are cervicofacial, thoracic, and abdominal; most cases are due to Actinomyces israelii, whereas other Actinomyces species are occasionally implicated. Actinomycosis usually occurs in immunocompetent persons, but may occur in persons with diminished host defenses.