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1.
J Surg Case Rep ; 2024(6): rjae253, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38828406

RESUMO

We present a 20-year-old patient with subglottic and tracheal stenosis was taken for a tracheal resection and end-to-end anastomosis. The patient's neck was positioned in hyperflexion using chin stitches to minimize tension at the anastomosis. On post-operative period, the patient developed paresthesias in upper and lower extremities associated with motor weakness. Magnetic resonance imaging was performed showing lesions compromising ventral spinal cord at the level of C4-C5 and C6-C7. Chin stitches were removed and neck flexion was reduced. The patient remained in the intensive care unit with vasopressors, physical therapy and intravenous fluid-therapy to maintain mean arterial pressure above 90 mmHg. After 3 weeks, the patient was discharged with no neurologic deficit. There are few cases reported of acute ischemic spinal injury following tracheal reconstruction. If this complication arises, neck posture should be corrected, maintenance of MAP above 90 mmHg and implementation of early physical therapy is key to improve neurologic outcomes.

2.
Materials (Basel) ; 17(6)2024 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-38541574

RESUMO

Diabetic retinopathy (RD) is a microvascular disease that can cause the formation of fragile neovessels, increasing the risk of hemorrhages and leading to vision loss. Current therapies are based on the intravitreal injection of anti-VEGF (vascular endothelial growth factor), which is invasive and can cause secondary effects. The development of new treatments that complement the current therapies is necessary to improve the patient's outcomes. Nanostructured formulations offer several advantages regarding drug delivery and penetration. In this research, a resveratrol nanosuspension (RSV-NS) was prepared and characterized using dynamic light scattering, field emission scanning electron microscopy, and infrared spectroscopy. The RSV-NS had an average particle size of 304.0 ± 81.21 nm with a PDI of 0.225 ± 0.036, and a spherical-like morphology and uniform particle distribution. Cell viability, proliferation, and migration were tested on endothelial cells (HMRECs). RSV-NS in a concentration of less than 18.75 µM did not have a cytotoxic effect on HMRECs. Likewise, proliferation and migration were significantly reduced compared to the unstimulated control at 37.5 µM. The RSV-NS did not present cytotoxic effects but decreased cell proliferation and migration, indicating that it could provide an important contribution to future medical implementations and could have a high potential to treat this disease.

3.
Rev. esp. enferm. dig ; 115(12): 745-746, Dic. 2023. ilus
Artigo em Inglês | IBECS | ID: ibc-228735

RESUMO

Dieulafoy's lesion is a rare vascular malformation that can cause massive acute gastrointestinal hemorrhage threatening the patient's life. This correspondence to the editor outlines the clinical presentation of a patient in whom, owing to the utilization of capsule endoscopy followed by subsequent colonoscopy, a diagnosis of hemorrhage resulting from a Dieulafoy's lesion located in the colon, a relatively uncommon site, was successfully established. Following intervention involving the application of hemoclips, the patient experienced a favorable clinical evolution.(AU)


Assuntos
Humanos , Masculino , Idoso de 80 Anos ou mais , Hemorragia Gastrointestinal , Doenças Vasculares/complicações , Cápsulas Endoscópicas
4.
Rev. biol. trop ; 71(1)dic. 2023.
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1449515

RESUMO

Introduction: The distribution of freshwater fishes in the Colombian Andes results from the interaction between historical and recent factors. Currently, the Andean landscape is facing rapid transformation processes. However, the knowledge regarding species distribution and environmental requirements is advancing slower than the transformations underway in the fluvial networks. Objective: To understand the conformation of the fish assemblage in the middle and lower Cauca River basin, considering the local environmental context before the construction of the Ituango Dam, and quantifying β diversity and its two components (turnover and nestedness) amongst local fish communities. Methods: 58 localities were monitored during nine years (between February 2010 and November 2018), the period before the dam's operation. The species richness (α-diversity), species turnover (β-diversity), and assemblage composition were estimated for the given localities. Results: 114 species were recorded, representing ~ 49 % of the total richness of known species for the Magdalena basin. The richness distribution showed that the number of species varies among the aquatic environments. Swamps presented the most significant number of species, followed by the Cauca River, while streams had the lowest values of richness. The spatial analyses of β-diversity revealed a high variation component in the study area due to species replacement between the aquatic environments. Conclusions: The implementation of long-term monitoring allowed us to recognize that the Cauca River basin conserves a great variety of species-rich environments. The species turnover indicates a high proportion of endemism or multiple sites with unique species. Finally, our study will serve as a baseline to verify, over time, whether the dam's construction is associated with essential changes in the structure of fish communities.


Introducción: La distribución de los peces de agua dulce en los Andes colombianos es el resultado de la interacción entre factores históricos y recientes. Actualmente, el paisaje Andino enfrenta procesos de rápida transformación. Sin embargo, el conocimiento sobre la distribución de las especies y sus requerimientos ambientales no avanza tan rápido como las transformaciones en curso en las redes fluviales. Objetivo: Comprender la conformación del ensamble de peces en la cuenca media y baja del río Cauca, considerando el contexto ambiental local antes de la construcción de la represa de Ituango, y cuantificar la diversidad beta y sus dos componentes (recambio y anidamiento) entre las comunidades de peces locales. Métodos: Se analizaron 58 localidades durante nueve años (entre febrero 2010 y noviembre 2018), período previo a la operación de la represa. La riqueza de especies (diversidad α), el recambio de especies (diversidad β) y la composición del conjunto se estimaron para las localidades dadas. Resultados: Se registraron 114 especies, que representan ~ 49 % de la riqueza total de especies conocidas para la cuenca del Magdalena. La distribución de la riqueza mostró que el número de especies varía entre los ambientes acuáticos. Las ciénagas presentaron el mayor número de especies, seguidas por el río Cauca, mientras que las quebradas presentaron los valores más bajos de riqueza. Los análisis espaciales de la diversidad β revelaron un alto componente de variación en el área de estudio debido al reemplazo de especies entre los ambientes acuáticos. Conclusiones: La implementación del monitoreo a largo plazo permitió reconocer que la cuenca del río Cauca conserva una gran variedad de ambientes ricos en especies. El recambio de especies indica una alta proporción de endemismo o múltiples sitios con especies únicas. Finalmente, nuestro estudio servirá como línea base para verificar, con el tiempo, si la construcción de la represa está asociada con cambios esenciales en la estructura de las comunidades de peces.

5.
Rev Esp Enferm Dig ; 115(12): 745-746, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38031903

RESUMO

Dieulafoy's lesion is a rare vascular malformation that can cause massive acute gastrointestinal hemorrhage threatening the patient's life. This correspondence to the editor outlines the clinical presentation of a patient in whom, owing to the utilization of capsule endoscopy followed by subsequent colonoscopy, a diagnosis of hemorrhage resulting from a Dieulafoy's lesion located in the colon, a relatively uncommon site, was successfully established. Following intervention involving the application of hemoclips, the patient experienced a favorable clinical evolution.


Assuntos
Endoscopia por Cápsula , Doenças Vasculares , Humanos , Hemorragia Gastrointestinal/diagnóstico por imagem , Hemorragia Gastrointestinal/etiologia , Doenças Vasculares/complicações
6.
J Med Entomol ; 60(4): 656-663, 2023 07 12.
Artigo em Inglês | MEDLINE | ID: mdl-37071084

RESUMO

Lucilia eximia (Wiedemann, 1819) (Diptera: Calliphoridae) is a blowfly with medical and forensic importance that shows genetic and color variation, however, these variations have not justified the description of new species. But in forensic entomology an accurate identification of species and subpopulations is crucial. We explored the genetic variation of L. eximia from eight localities, in five natural regions in Colombia using two mitochondrial fragments, including the standard locus for insect identification COI and the Cytb-tRNA-Ser-ND1 region. We found significant differentiation at COI and Cytb-tRNA-Ser-ND1 level, characterizing two lineages and revealing a deep and significant genetic split. High values of FST and genetic distances supported the two lineages. The origin of the divergence of L. eximia remains to discover. Examining whether the lineages have diverse ecological and biological behaviors could be a significant impact on the use of L. eximia in forensic and medical science. Our results could have relevant implications for the use of post-mortem interval estimation based on insect evidence, as well as our sequences improve the database used in DNA-based methods for identifying forensically important flies.


Assuntos
Dípteros , Animais , Dípteros/genética , Calliphoridae/genética , Colômbia , DNA , RNA de Transferência
7.
PLoS One ; 17(7): e0263143, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35895627

RESUMO

Aedes spp. comprise the primary group of mosquitoes that transmit arboviruses such as dengue, Zika, and chikungunya viruses to humans, and thus these insects pose a significant burden on public health worldwide. Advancements in next-generation sequencing and metagenomics have expanded our knowledge on the richness of RNA viruses harbored by arthropods such as Ae. aegypti and Ae. albopictus. Increasing evidence suggests that vector competence can be modified by the microbiome (comprising both bacteriome and virome) of mosquitoes present in endemic zones. Using an RNA-seq-based metataxonomic approach, this study determined the virome structure, Wolbachia presence and mitochondrial diversity of field-caught Ae. aegypti and Ae. albopictus mosquitoes in Medellín, Colombia, a municipality with a high incidence of mosquito-transmitted arboviruses. The two species are sympatric, but their core viromes differed considerably in richness, diversity, and abundance; although the community of viral species identified was large and complex, the viromes were dominated by few virus species. BLAST searches of assembled contigs suggested that at least 17 virus species (16 of which are insect-specific viruses [ISVs]) infect the Ae. aegypti population. Dengue virus 3 was detected in one sample and it was the only pathogenic virus detected. In Ae. albopictus, up to 11 ISVs and one plant virus were detected. Therefore, the virome composition appears to be species-specific. The bacterial endosymbiont Wolbachia was identified in all Ae. albopictus samples and in some Ae. aegypti samples collected after 2017. The presence of Wolbachia sp. in Ae. aegypti was not related to significant changes in the richness, diversity, or abundance of this mosquito's virome, although it was related to an increase in the abundance of Aedes aegypti To virus 2 (Metaviridae). The mitochondrial diversity of these mosquitoes suggested that the Ae. aegypti population underwent a change that started in the second half of 2017, which coincides with the release of Wolbachia-infected mosquitoes in Medellín, indicating that the population of wMel-infected mosquitoes released has introduced new alleles into the wild Ae. aegypti population of Medellín. However, additional studies are required on the dispersal speed and intergenerational stability of wMel in Medellín and nearby areas as well as on the introgression of genetic variants in the native mosquito population.


Assuntos
Aedes , Vírus de Insetos , Vírus de RNA , Viroma , Aedes/classificação , Aedes/virologia , Animais , Colômbia , Vírus de Insetos/genética , Mosquitos Vetores/virologia , Vírus de RNA/genética , Viroma/genética , Wolbachia/genética
9.
Sci Rep ; 12(1): 8333, 2022 05 18.
Artigo em Inglês | MEDLINE | ID: mdl-35585133

RESUMO

Dengue is a growing global threat in some of the world's most rapidly growing landscapes. Research shows that urbanization and human movement affect the spatial dynamics and magnitude of dengue outbreaks; however, precise effects of urban growth on dengue are not well understood because of a lack of sufficiently fine-scaled data. We analyzed nine years of address-level dengue case data in Medellin, Colombia during a period of public transit expansion. We correlate changes in the spread and magnitude of localized outbreaks to changes in accessibility and usage of public transit. Locations closer to and with a greater utilization of public transit had greater dengue incidence. This relationship was modulated by socioeconomic status; lower socioeconomic status locations experienced stronger effects of public transit accessibility and usage on dengue incidence. Public transit is a vital urban resource, particularly among low socioeconomic populations. These results highlight the importance of public health services concurrent with urban growth.


Assuntos
Vírus da Dengue , Dengue , Colômbia/epidemiologia , Dengue/epidemiologia , Surtos de Doenças , Humanos , Incidência , Urbanização
10.
Neotrop. ichthyol ; 20(1): e210091, 2022. graf
Artigo em Inglês | LILACS, VETINDEX | ID: biblio-1365210

RESUMO

We describe the change in the fish community of the Porce River in Magdalena River Basin, Colombia, following the construction of the Porce III hydropower reservoir based on 13 years of monitoring data. The results show a clear reduction of the number of native species, which have been supplanted by colonizing non-native species, especially in the reservoir. Four native species detected prior to dam construction have apparently disappeared, but 12 new species were registered post-construction. We analyzed spatial changes in beta diversity in the aquatic environments surrounding the dam. The new environment generated by the reservoir presents a unique species composition and contributes significantly to the total beta diversity of the system. Altogether three distinct new fish assemblages emerged following reservoir formation and there are now six assemblages where there had previously been three. This dramatic change, already visible within a decade of construction, highlights just how strong of an impact dam construction has on habitats and how rapidly fish communities react in this hotspot for endemic fish diversity. Our findings demonstrate the importance of monitoring fish communities for revealing the impact of damming on river ecosystems and informs potential complementary fish diversity inventories elsewhere in the Magdalena River basin.(AU)


Describimos el cambio en la comunidad de peces del río Porce en la cuenca del río Magdalena en Colombia luego de la construcción del embalse hidroeléctrico Porce III con base en 13 años de datos de monitoreo. Los resultados mostraron una reducción de especies nativas y, el embalse ha sido colonizado por especies no nativas. A lo largo del monitoreo cuatro especies desaparecieron de las capturas, y se registró la aparición de 12 especies nuevas después de la construcción del embalse. Analizamos los cambios espaciales en la diversidad beta en los ambientes acuáticos que rodean la presa. El nuevo entorno generado por el embalse presenta una composición de especies única; en total, surgieron tres nuevos ensamblajes de peces distintos después de la formación del embalse y ahora hay seis ensamblajes. Este cambio, ya visible a una década de la construcción, resalta cuán fuerte es el impacto que tiene la construcción de presas en los hábitats y cuán rápido reaccionan las comunidades de peces. Nuestros hallazgos demuestran la importancia de monitorear las comunidades de peces para revelar el impacto de las represas en los ecosistemas fluviales, además permite complementar los inventarios de diversidad en la cuenca del río Magdalena.(AU)


Assuntos
Animais , Reservatórios de Água , Ecossistema , Biodiversidade , Peixes
11.
Rev. colomb. gastroenterol ; 36(4): 455-462, oct.-dic. 2021. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-1360969

RESUMO

Resumen Introducción y objetivos: el "efecto fin de semana" se define como un incremento en la mortalidad en pacientes que ingresan a centros asistenciales durante el fin de semana o días festivos. Este estudio se realizó para evaluar el posible "efecto fin de semana" en pacientes con hemorragia digestiva superior (HDS) con base en una experiencia de 3 años en un hospital de alta complejidad en Latinoamérica. Materiales y métodos: estudio observacional descriptivo realizado entre 2016 y 2018. Se describieron las características demográficas, factores de riesgo, síntomas de ingreso, hallazgos endoscópicos y diferentes intervenciones médicas. Además, se compararon los tiempos de realización de endoscopia, estancia hospitalaria y mortalidad entre los pacientes admitidos durante el fin de semana frente a días entre semana. Resultados: el análisis incluyó 274 pacientes en fines de semana y festivos (39,1 %) frente a pacientes en días entre semana (60,9 %). La mediana de edad fue de 68,5 años (rango intercuartílico [RIC]: 53-79), el 56,6 % fueron hombres. Las manifestaciones más comunes fueron melenas y hematemesis. La úlcera péptica fue el diagnóstico endoscópico más común (48,7 %). Los tiempos de estancia hospitalaria (7,38 ± 8,7 frente a 7,38 ± 7,1; p = 0,234) y mortalidad (1,9 % frente a 4,2 %; p = 0,274) fueron similares en ambos grupos. Se realizó una mayor cantidad de endoscopias después de las 24 horas en pacientes ingresados el fin de semana (19,6 % frente a 9,6 %; p = 0,041). Conclusiones: en esta cohorte no se presentó el "efecto fin de semana", no se observan diferencias en relación con la estancia hospitalaria, ni con la mortalidad en pacientes ingresados por HDS.


Abstract Introduction and Objectives: The "Weekend Effect" refers to an increase in mortality of patients admitted to health care centers on weekends or holidays. This study was performed to assess the impact of weekend admissions in patients with upper gastrointestinal bleeding (UGIB) based on a three year-experience in a high-complexity hospital in Latin America. Materials and Methods: A descriptive observational study was performed between 2016 and 2018. Data on demographic characteristics, risk factors, symptoms, endoscopic findings, and medical treatment was described. Moreover, the time to perform an endoscopy, the length of hospital stay, and the mortality level among patients admitted on weekends were compared with the same factors during the week. Results: The analysis included 274 patients admitted during the weekend and holidays (39.1%) versus patients admitted during the week (60.9%). The median age was 68.5 years old (interquartile range [IQR]: 53-79), and 56.6% were men. The most common conditions were tarry stools and hematemesis. Peptic ulcer was the most common endoscopic diagnosis (48.7%). Similar results were found in the length of hospital stay (7,38 ± 8,7 versus 7,38 ± 7,1; p = 0,234) and mortality groups (1,9 % versus 4,2 %; p = 0,274). A higher number of endoscopies 24 hours after the patient was admitted was performed (19,6 % versus 9,6 %; p = 0,041). Conclusions: The "Weekend Effect" was not present in the analyzed group, and there are no significant differences related to the length of hospital stay or the mortality of patients diagnosed with UGIB.


Assuntos
Humanos , Masculino , Feminino , Terapêutica , Endoscopia , Hemorragia , Fatores de Risco , Mortalidade , Hospitais
12.
Steroids ; 175: 108916, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34492258

RESUMO

We aimed to investigate the effects of high doses of nandrolone decanoate and resistance training (RT) on the proteomic profile of the left ventricle (LV) of rats, using a label-free quantitative approach. Male rats were randomized into four groups: untrained vehicle (UTV), trained vehicle (TV), untrained nandrolone (UTN), and trained nandrolone (TN). Rats were familiarized with the exercise training protocol (jump exercise) for one week. Jump-exercise was performed five days a week for 6 weeks, with 30 s of inter-set rest intervals. Nandrolone was administrated for 6 weeks (5 mg/kg, twice a week, via intramuscular). Systolic and diastolic arterial pressure and heart rate were measured 48 h post-training. LV was isolated and collagen content was measured. The expression of cardiac proteins was analyzed by ultra-efficiency liquid chromatography with mass spectrometry high / low collision energy (UPLC/MSE). Nandrolone and RT led to cardiac hypertrophy, even though high doses of nandrolone counteracted the RT-induced arterial pressures lowering. Nandrolone also affected the proteome profile negatively in LV of rats, including critical proteins related to biological processes (metabolism, oxidative stress, inflammation), structural function and membrane transporters. Our findings show physiological relevance since high doses of nandrolone induced detrimental effects on the proteome profile of heart tissue and hemodynamic parameters of rats. Furthermore, as nandrolone abuse has become increasingly common among recreational athletes and casual fitness enthusiasts, we consider that our findings have clinical relevance as well.


Assuntos
Nandrolona
13.
Artigo em Espanhol | CUMED, LILACS | ID: biblio-1408633

RESUMO

Introducción: La vejez está subvalorada, poco se piensa en el bienestar físico y psicosocial del anciano. La enfermedad cerebrovascular tiene como factores de riesgo comorbilidades como la hipertensión arterial, la diabetes mellitus, la dislipidemia, cardiopatías o malos estilos de vida como el consumo de cigarrillo, la obesidad y la poca actividad física, todos estos comunes en esta etapa de la vida. Objetivo: Identificar los factores de riesgo que presentan los adultos mayores para sufrir enfermedad cerebrovascular de un centro gerontológico de la ciudad de Medellín. Métodos: Fue una investigación descriptiva, de tipo transversal; se indagaron 37 adultos mayores con historias clínicas y exámenes de laboratorio. Se midieron los niveles de hemoglobina glicosilada, colesterol total, colesterol de baja densidad, colesterol de alta densidad y triglicéridos. Resultados: Se evidenció que la población era en su mayoría de sexo masculino con 51,4 por ciento y el sexo femenino con 48,6 por ciento; con rango de edad entre 60 y 70 años el 51,4 por ciento. Los factores de riesgo más relevantes fueron el índice de masa corporal mayor o igual a 25 con (75,7 por ciento), hipertensión arterial y no realizar actividad física. Conclusiones: Se logró determinar los principales factores de riesgo que tienen estos adultos mayores para sufrir enfermedad cerebrovascular; con resultados algunos similares y otros diferentes a estudios a nivel mundial. Con actividades de promoción y prevención se pueden intervenir estilos de vida de la población(AU)


Introduction: Old age is undervalued; little is thought about the physical and psychosocial well-being of the elderly. Among the risk factors of cerebrovascular disease, there are comorbidities, such as high blood pressure, diabetes mellitus, dyslipidemia and cardiopathies, or poor lifestyles like cigarette smoking, obesity and little physical activity, all of which are common at this stage of life. Objective: To identify, in a gerontological center in Medellín City, the risk factors that older adults present for being affected by cerebrovascular disease. Methods: This was a descriptive and cross-sectional research carried out with 37 older adults with medical antecedents and laboratory tests. The levels of glycated hemoglobin, total cholesterol, low-density and high-density cholesterol, as well as triglycerides were measured. Results: It was evidenced that the population was mostly male (51.4 por ciento), while females accounted for 48.6 por ciento. Their age range was mostly between 60 and 70 years (51.4 por ciento). The most relevant risk factors were body mass index greater than or equal to 25 (75.7 por ciento), arterial hypertension and not doing any physical activity. Conclusions: It was possible to determine the main risk factors for these older adults being affected by cerebrovascular disease; in this respect, some results were similar to and others were different from studies worldwide. With promotion and prevention activities, lifestyles of the population can be intervened(AU)


Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Qualidade de Vida , Infarto Cerebral/epidemiologia , Fatores de Risco , Acidente Vascular Cerebral/epidemiologia , Obesidade/complicações , Epidemiologia Descritiva , Estudos Transversais
14.
Artigo em Inglês | MEDLINE | ID: mdl-34204166

RESUMO

Surveillance and control activities for virus-transmitting mosquitoes have primarily focused on dwellings. There is little information about viral circulation in heavily trafficked places such as schools. We collected and analyzed data to assess the presence and prevalence of dengue, chikungunya, and Zika viruses in mosquitoes, and measured Aedes indices in schools in Medellín (Colombia) between 2016-2018. In 43.27% of 2632 visits we collected Aedes adults, creating 883 pools analyzed by RT-PCR. 14.27% of pools yielded positive for dengue or Zika (infection rates of 1.75-296.29 for Aedes aegypti). Ae. aegypti was more abundant and had a higher infection rate for all studied diseases. Aedes indices varied over time. There was no association between Aedes abundance and mosquito infection rates, but the latter did correlate with cases of arboviral disease and climate. Results suggest schools are important sources of arbovirus and health agencies should include these sites in surveillance programs; it is essential to know the source for arboviral diseases transmission and the identification of the most population groups exposed to these diseases to research and developing new strategies.


Assuntos
Vírus da Dengue , Dengue , Infecção por Zika virus , Zika virus , Animais , Colômbia , Dengue/epidemiologia , Mosquitos Vetores , Instituições Acadêmicas , Infecção por Zika virus/epidemiologia
15.
Rev. argent. neurocir ; 35(2): 160-171, jun. 2021. ilus
Artigo em Espanhol | LILACS, BINACIS | ID: biblio-1398691

RESUMO

En las ultimas décadas, ha habido un cambio en la formación en las especialidades quirúrgicas, lo cual ha llevado a plantearse la necesidad de adquisición de habilidades por fuera del quirófano por medio de la simulación. El objetivo de este trabajo es demostrar que el uso de placentas humanas con modelo craneal tridimensional (3D), es un método de alta fidelidad y retroalimentación para el desarrollo de técnicas microquirúrgicas. Se realizó un estudio de evaluación técnica en el Laboratorio de Microcirugía Dr. Evandro de Oliveira del Hospital de la Beneficiencia de Portugal de São Paulo, utilizando 15 placentas con técnicas de coloración y preservación vascular con silicona para moldes; realizando ejercicio de anastomosis vasculares, ejercicios de disección parenquimatosa placentaria que remedan la disección aracnoidea y del valle silviano, además de simulación de resección de tumores. Cualitativamente la placenta humana es un método con alta fidelidad y retroalimentación, además, es de acceso universal para la adquisición de habilidades microquirúrgicas, que asociada a un modelo craneal 3D permite el perfeccionamiento de craneotomías, coordinación visomotriz, propiocepción y relación de profundidad que se requieren para abordajes neuroquirúrgicos.


In the last decades, there has been a change in training in surgical specialties, which has led to the need to acquire skills outside the operating room through simulation. The aim of this work is to demonstrate that the use of human placentas with a three-dimensional (3D) cranial model is a high fidelity and feedback method for the development of microsurgical techniques. A technical evaluation study was carried out in the Dr. Evandro de Oliveira Microsurgery Laboratory of the Hospital de la Beneficiencia de Portugal in São Paulo, using 15 placentas with coloration techniques and vascular preservation with silicone for molds; performing vascular anastomosis, placental parenchymal dissection exercises that mimic arachnoid and sylvian fissure dissection, in addition to simulating tumor resection. Qualitatively, the human placenta is a method with high fidelity and feedback, and it is also universally accessible for the acquisition of microsurgical skills, which, associated with a 3D cranial model, allows the refinement of the craniotomies, visomotor coordination, proprioception, and depth relationship required for neurosurgical approaches.


Assuntos
Microcirurgia , Salas Cirúrgicas , Placenta , Silicones , Especialidades Cirúrgicas , Exercício de Simulação , Métodos
16.
Infect Genet Evol ; 85: 104434, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32580028

RESUMO

Due to the rapid spread of Zika virus (ZIKV) infection after its emergence in the Americas in 2015 and its relationship with birth defects, it became declared a Public Health Emergency of International Concern (WHO). The main mechanism by which this virus circulates in nature is horizontal transmission between vectors and humans. However, it has been suggested that vertical transmission (parent to offspring infection) or venereal mosquito-mosquito transmission may have an important role in viral populations maintenance during inter-epidemic periods. In this study we evaluate the presence of ZIKV in males and females of Aedes aegypti and Ae. albopictus in Medellín, Colombia, throughout the post-epidemic period of 2017 and 2018. A total of 7986 mosquitoes Aedes sp. resting within houses were captured and grouped in 2768 pools; 146 of these were RT-PCR positive for ZIKV, of which 38 (26%) were male mosquito pools (36 of Ae. aegypti and 2 of Ae. albopictus). The partial NS5 gene was sequenced in all ZIKV PCR-positive pools to confirm the ZIKV presence throughout spatial and temporal sampling. The results suggest a vector role of ZIKV by Ae. Albopictus; and because it is well known that male mosquitoes are not hematophagous, the high rate detection of ZIKV in male Aedes mosquitoes pools supports the existence of vertical or venereal transmission in Medellín, which can contribute to ZIKV maintenance during low transmission periods. This study provides a better understanding of the population dynamics of ZIKV in an endemic region during an inter-epidemic period and supports alternative transmission pathways as a mechanism to maintain endemism of this arbovirus.


Assuntos
Aedes/virologia , Infecção por Zika virus/epidemiologia , Infecção por Zika virus/virologia , Zika virus/genética , Zika virus/isolamento & purificação , Animais , Colômbia/epidemiologia , Vetores de Doenças , Feminino , Humanos , Transmissão Vertical de Doenças Infecciosas , Masculino , Mosquitos Vetores/virologia , Filogenia , RNA Viral , Proteínas não Estruturais Virais/genética , Infecção por Zika virus/transmissão
17.
PLoS One ; 15(5): e0232779, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32365083

RESUMO

Apoptosis of neurovascular cells, including astroglial cells, contributes to the pathogenesis of diseases in which neurovascular disruption plays a central role. Bim is a pro-apoptotic protein that modulates not only apoptosis but also various cellular functions such as migration and extracellular matrix protein expression. Astroglial cells act as an intermediary between neural and vascular cells facilitating retinal vascular development and remodeling while maintaining normal vascular function and neuronal integrity. We previously showed that Bim deficient (Bim -/-) mice were protected from hyperoxia mediated vessel obliteration and ischemia-mediated retinal neovascularization. However, the underlying mechanisms and more specifically the role Bim expression in astroglial cells play remains elusive. Here, using retinal astroglial cells prepared from wild-type and Bim -/- mice, we determined the impact of Bim expression in retinal astroglial cell function. We showed that astroglial cells lacking Bim expression demonstrate increased VEGF expression and altered matricellular protein production including increased expression of thrombospondin-2 (TSP2), osteopontin and SPARC. Bim deficient astroglial cells also exhibited altered proliferation, migration, adhesion to various extracellular matrix proteins and increased expression of inflammatory mediators. Thus, our data emphasizes the importance of Bim expression in retinal astroglia cell autonomous regulatory mechanisms, which could influence neurovascular function.


Assuntos
Astrócitos/metabolismo , Proteína 11 Semelhante a Bcl-2/genética , Inflamação/genética , Retina/metabolismo , Animais , Apoptose/genética , Astrócitos/patologia , Movimento Celular/genética , Proliferação de Células/genética , Proteínas da Matriz Extracelular/genética , Regulação da Expressão Gênica/genética , Humanos , Inflamação/metabolismo , Inflamação/patologia , Camundongos , Neovascularização Fisiológica/genética , Neurônios/metabolismo , Osteonectina/genética , Osteopontina/genética , Retina/patologia , Trombospondinas/genética , Fator A de Crescimento do Endotélio Vascular/genética
18.
PLoS One ; 15(4): e0231752, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32330152

RESUMO

Astrocytes (AC) are the most abundant cells in the central nervous system. In the retina, astrocytes play important roles in the development and integrity of the retinal neurovasculature. Astrocytes dysfunction contributes to pathogenesis of a variety of neurovascular diseases including diabetic retinopathy. Recent studies have demonstrated the expression of Cyp1b1 in the neurovascular cells of the central nervous system including AC. We recently showed retinal AC constitutively express Cyp1b1, and global Cyp1b1-deficiency (Cyp1b1-/-) attenuates retinal ischemia-mediated neovascularization in vivo and the pro-angiogenic activity of retinal vascular cells in vitro. We also demonstrated that Cyp1b1 expression is a key regulator of retinal AC function. However, the underlying mechanisms involved need further investigation. Here we determined changes in the transcriptome profiles of Cyp1b1+/+ and Cyp1b1-/- retinal AC by RNA sequencing. We identified 585 differentially expressed genes, whose pathway enrichment analysis revealed the most significant pathways impacted in Cyp1b1-/- AC. These genes included those of axon guidance, extracellular matrix proteins and their receptors, cancer, cell adhesion molecules, TGF-ß signaling, and the focal adhesion modulation. The expression of a selected set of differentially expressed genes was confirmed by RT-qPCR analysis. To our knowledge, this is the first report of RNAseq investigation of the retinal AC transcriptome and the molecular pathways impacted by Cyp1b1 expression. These results demonstrated an important role for Cyp1b1 expression in the regulation of various retinal AC functions, which are important in neurovascular development and integrity.


Assuntos
Astrócitos/fisiologia , Adesão Celular/genética , Citocromo P-450 CYP1B1/metabolismo , Regulação da Expressão Gênica/fisiologia , Retina/fisiologia , Animais , Movimento Celular/genética , Células Cultivadas , Citocromo P-450 CYP1B1/genética , Feminino , Masculino , Camundongos , Camundongos Knockout , Cultura Primária de Células , RNA-Seq , Retina/citologia
19.
Transplant Proc ; 52(5): 1402-1408, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32220480

RESUMO

Measurement of immunosuppressive drug concentrations cyclosporine A (CyA), tacrolimus (TAC), sirolimus (SIR), and everolimus (EVE) in blood is an important application of therapeutic drug monitoring. These immunosuppressive agents are used in combined regimens and nowadays the liquid chromatography and tandem mass spectrometry is the best option for simultaneous analysis of these drugs in one short run. We developed an liquid chromatography and tandem mass spectrometry methodology in-house to measure the combination of immunosuppressants in a single blood sample from transplant patients in Brazil. We analyzed 235 combinations of 4 immunosuppressive drugs in patient blood to validate this study. The measuring ranges were 9 to 1000 ng/mL for CyA and 2 to 50 ng/mL for TAC, SIR, and EVE. Accuracy of the method was between 83.87% and 126.6% (coefficient of determination [r2] > 0.995). Validation of variation was ≤15% for lower limit of quantification. In our analysis 20% of patients treated with EVE showed concentration range of 6 to 6.9 ng/mL, 28% of patients treated with SIR showed a concentration range of 4 to 4.9 ng/mL to TAC, 22% of patients showed concentration range of 5 to 5.9 ng/mL, and finally 50% of patients treated with CyA showed concentration range of 20 to 30 ng/mL. Our routine laboratory was able to implement this new methodology in-house to measure simultaneous CyA, TAC, SIR, and EVE in a single blood sample from transplant patients with a sensibility and rapid quantification analysis.


Assuntos
Cromatografia Líquida/métodos , Monitoramento de Medicamentos/métodos , Imunossupressores/sangue , Espectrometria de Massas em Tandem/métodos , Brasil , Ciclosporina/sangue , Everolimo/sangue , Feminino , Rejeição de Enxerto/prevenção & controle , Humanos , Transplante de Órgãos/efeitos adversos , Sirolimo/sangue , Tacrolimo/sangue
20.
CES med ; 33(3): 175-181, sep.-dic. 2019. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1055546

RESUMO

Abstract Introduction: The Zika virus has generated serious epidemics in the different countries where it has been reported and Colombia has not been the exception. Although in these epidemics Aedes aegypti traditionally has been the primary vector, other species could also be involved in the transmission. Methods: Mosquitoes were captured with entomological aspirators on a monthly ba sis between March and September of 2017, in four houses around each of the 250 entomological surveillance traps installed by the Secretaria de Sa lud de Medellin (Colombia). Additionally, 70 Educational Institutions and 30 Health Centers were visited each month. Results: 2 504 mosquitoes were captured and grouped into 1045 pools to be analyzed by RT-PCR for the detection of Zika virus. Twenty-six pools of Aedes aegypti, two pools of Ae. albopictus and one for Culex quinquefasciatus were positive for Zika virus. Conclusion: The presence of this virus in the three species and the abundance of these species in the different sectors of the city, suggests that the control strategies should be addressed to all species that could be potential vec tors until the vectorial role of Ae. albopictus and Culex quinquefasciatus is completely elucidated in the transmission of the Zika virus.


Resumen Introducción: El virus Zika ha generado serias epidemias en los diferentes países en donde se ha reportado, Colombia no ha sido la excepción. Aunque en estas epidemias el vector presuntamente involucrado ha sido Aedes aegypti, otras especies también podrían estar implicadas en su transmisión. Meto dología: en el marco del Programa de vigilancia virológica en mosquitos de la Secretaría de Salud de Medellín (Colombia). Resultados: entre marzo y septiembre de 2017 se capturaron 2 504 mosquitos en predios visitados durante los levantamientos de índices entomológicos. El material entomo lógico fue agrupado en 1 045 pooles para ser analizados por RT-PCR para la detección de virus Zika. Resultaron positivos para virus Zika 26 pooles de Aedes aegypti, dos pooles de Ae. albopictus y uno para Culex quinquefasciatus. Conclusión: la presencia de este virus en las tres especies y su abundancia en los distintos sectores de la ciudad sugieren que las estrategias de control deban dirigirse a todos los potenciales vectores, hasta tanto no se dilucide comple tamente el papel vectorial de Ae. albopictus y Cx. quinquefasciatus en la transmisión del virus Zika.

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