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1.
Sci Rep ; 14(1): 16788, 2024 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-39039152

RESUMO

Motorized spiral enteroscopy (MSE) enhances small bowel exploration, but the optimal target population for this technique is unknown. We aimed to identify the target population for MSE by evaluating its efficacy and safety, as well as detecting predictors of efficacy. A prospective multicenter observational study was conducted at 9 tertiary hospitals in Spain, enrolling patients between June 2020-2022. Analyzed data included demographics, indications for the procedure, exploration time, depth of maximum insertion (DMI), technical success, diagnostic yield, interventional yield, and adverse events (AE) up to 14 days from enteroscopy. Patients with prior gastrointestinal surgery, unsuccessful balloon enteroscopy and small bowel strictures were analyzed. A total of 326 enteroscopies (66.6% oral route) were performed in 294 patients (55.1% males, 65 years ± 21). Prior abdominal surgery was present in 50% of procedures (13.5% gastrointestinal surgery). Lower DMI (162 vs 275 cm, p = 0.037) and diagnostic yield (47.7 vs 67.5%, p = 0.016) were observed in patients with prior gastrointestinal surgery. MSE showed 92.2% technical success and 56.9% diagnostic yield after unsuccessful balloon enteroscopy (n = 51). In suspected small bowel strictures (n = 49), the finding was confirmed in 23 procedures (46.9%). The total AE rate was 10.7% (1.8% classified as major events) with no differences related to prior gastrointestinal/abdominal surgery, unsuccessful enteroscopy, or suspected small bowel strictures. The study demonstrates that MSE has a lower diagnostic yield and DMI in patients with prior gastrointestinal surgery but is feasible after unsuccessful balloon-enteroscopy and in suspected small bowel strictures without safety concerns.


Assuntos
Endoscopia Gastrointestinal , Intestino Delgado , Humanos , Masculino , Feminino , Idoso , Estudos Prospectivos , Pessoa de Meia-Idade , Endoscopia Gastrointestinal/métodos , Endoscopia Gastrointestinal/efeitos adversos , Intestino Delgado/cirurgia , Intestino Delgado/diagnóstico por imagem , Espanha , Idoso de 80 Anos ou mais , Adulto
2.
Endosc Int Open ; 12(3): E344-E351, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38481597

RESUMO

Background and study aims In 2019, the European Society of Gastrointestinal Endoscopy (ESGE) created a working group to develop technical and quality standards for small-bowel capsule endoscopy (SBCE) to improve the daily practice of endoscopy services. They developed 10 quality parameters, which have yet to be tested in a real-life setting. Our study aimed to evaluate the accomplishment of the quality standards in SBCE established by the ESGE in several Spanish centers. Materials and methods An online survey of 11 multiple-choice questions related to the ESGE performance measures was sent to Spanish centers with experience in SBCE. In order to participate and obtain reliable data, at least 100 questionnaires had to be answered per center because that is the minimum number established by ESGE. Results 20 centers participated in the study, compiling 2049 SBCEs for the analysis. Only one of 10 performance measures (cecal visualization) reached the minimum standard established by the ESGE. In five of 10 performance measures (Indication, lesion detection rate, terminology, and retention rate) the minimum standard was nearly achieved. Conclusions Our study is the first multicenter study regarding SBCE quality performance measures in a real setting. Our results show that the minimum standard is hardly reached in most procedures, which calls into question their clinical applicability in real life. We suggest performing similar studies in other countries to evaluate whether there is a need for quality improvement programs or a need to reevaluate the minimum and target values published so far.

3.
ISME J ; 18(1)2024 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-38366016

RESUMO

Bacterivorous protists are thought to serve as training grounds for bacterial pathogens by subjecting them to the same hostile conditions that they will encounter in the human host. Bacteria that survive intracellular digestion exhibit enhanced virulence and stress resistance after successful passage through protozoa but the underlying mechanisms are unknown. Here we show that the opportunistic pathogen Burkholderia cenocepacia survives phagocytosis by ciliates found in domestic and hospital sink drains, and viable bacteria are expelled packaged in respirable membrane vesicles with enhanced resistance to oxidative stress, desiccation, and antibiotics, thereby contributing to pathogen dissemination in the environment. Reactive oxygen species generated within the protozoan phagosome promote the formation of persisters tolerant to ciprofloxacin by activating the bacterial SOS response. In addition, we show that genes encoding antioxidant enzymes are upregulated during passage through ciliates increasing bacterial resistance to oxidative radicals. We prove that suppression of the SOS response impairs bacterial intracellular survival and persister formation within protists. This study highlights the significance of protozoan food vacuoles as niches that foster bacterial adaptation in natural and built environments and suggests that persister switch within phagosomes may be a widespread phenomenon in bacteria surviving intracellular digestion.


Assuntos
Antibacterianos , Burkholderia cenocepacia , Animais , Humanos , Antibacterianos/farmacologia , Burkholderia cenocepacia/genética , Resposta SOS em Genética , Comportamento Predatório , Estresse Oxidativo
4.
Acta Trop ; 249: 107053, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37898478

RESUMO

Puya alpestris, P. berteroniana and P. chilensis (Bromeliaceae) are terrestrial plants present in north-central Chile, considered important part of the shrub flora due to their abundance and close interaction with animals. A previous study showed that bromeliad cover positively correlates with the abundance of the sylvatic triatomine vector Mepraia spinolai, only when infected by the protozoan Trypanosoma cruzi, the etiological agent of Chagas disease. Here, we assessed the biological interactions and abiotic conditions provided by these Puya species to M. spinolai. During the austral summers of 2015 and 2016, we sampled 17 sites with presence of M. spinolai colonies. In each site, we estimated the presence of bromeliad and its cover proportion, and placed a camera trap for three months near a M. spinolai colony to record the vertebrates potentially interacting with this triatomine. Three of the camera traps were placed right in front of M. spinolai-colonized bromeliads. At the same time, triatomines present under these bromeliads were collected to assess their blood meal by Next Generation Sequencing. Between July 2017 and January 2018, we examined the abiotic conditions (temperature and humidity) under bromeliad, under rocks and at ground level. We detected 40 vertebrate species associated to Puya spp. (18 birds, 16 mammals, and 6 reptiles). Puya spp. are a resource for keystone species in T. cruzi sylvatic transmission, including small mammals (Octodon degus, Phyllotis darwini) and lizard species (Liolaemus spp.), detecting a positive association between bromeliad presence and availability of reptiles and non-domestic mammals. Native rodents and humans were the most represented vertebrates in the diet of M. spinolai collected under bromeliads. Temperatures were more stable under bromeliad, showing lower amplitude (up to 14.3 °C) compared to under rocks (23.7 °C) or at ground level (49.6 °C). Bromeliads present in the semiarid-Mediterranean ecosystem provide feeding opportunities for triatomines, and act as buffer of abiotic conditions reducing daily thermal amplitude. The presence of bromeliads near human settlements should be carefully monitored, especially because their leaves are consumed by people and browsed by livestock present in endemic areas of Chagas disease.


Assuntos
Doença de Chagas , Lagartos , Octodon , Triatominae , Trypanosoma cruzi , Animais , Humanos , Ecossistema , Roedores , Mamíferos
6.
Rev. colomb. cir ; 38(4): 747-752, 20230906. fig
Artigo em Espanhol | LILACS | ID: biblio-1511134

RESUMO

Introducción. La neumatosis intestinal se define como la presencia de quistes aéreos en la pared del tracto digestivo, a nivel submucoso o subseroso, que comprometen principalmente el intestino delgado. Las manifestaciones clínicas son inespecíficas y los hallazgos imagenológicos son fundamentales en el enfoque diagnóstico. El manejo puede ser médico o quirúrgico, dependiendo del compromiso intestinal y las complicaciones asociadas. Caso clínico. Hombre de 78 años, que ingresó por cuadro de dolor abdominal crónico, con hallazgos imagenológicos de neumoperitoneo. Al ser llevado a intervención quirúrgica se encontró neumatosis intestinal masiva del íleon, requiriendo resección intestinal. Resultado. El paciente presentó una evolución postoperatoria satisfactoria y fue dado de alta, sin complicaciones. Conclusión. La neumatosis intestinal es una enfermedad poco frecuente, que se presenta principalmente en hombres. La sospecha diagnóstica se confirma con imágenes tomográficas. Los pacientes candidatos para el manejo médico deben presentar causas con curso benigno, sin compromiso hemodinámico ni complicaciones. El manejo quirúrgico se reserva para pacientes con abdomen agudo o signos de sepsis.


Introduction. Intestinal pneumatosis is defined as the presence of air cysts in the wall of the digestive tract at the submucosal or subserosal level, mainly compromising the small intestine. The clinical manifestations of the disease are nonspecific, and the imaging findings are essential in the diagnostic approach. Management can be conservative and/or surgical depending on the intestinal compromise and associated complications. Clinical case. The following is the case of a 78-year-old man, who was admitted due to chronic abdominal pain with imaging findings of pneumoperitoneum. Patient underwent surgery and a massive ileum pneumatosis was found, requiring intestinal resection. Results. The patient ́s postoperative course was uneventful, and he was discharged without further complications. Conclusions. Intestinal pneumatosis is an uncommon disease, which mostly affect men population. Clinical suspicion of this condition should be confirmed with abdominal tomography. Candidates for medical management are those with benign course pathologies without hemodynamic compromise and/or complications. Surgical management should be reserved for patients with acute abdomen or sepsis.


Assuntos
Humanos , Pneumatose Cistoide Intestinal , Pneumoperitônio , Anastomose Cirúrgica , Terapêutica , Abdome Agudo , Intestino Delgado
7.
Salud Boliviana ; 22(2): 16-19, Agosto, 2023. Tab.
Artigo em Espanhol | LIBOCS | ID: biblio-1538376

RESUMO

Objetivo: Determina la prevalencia de malformaciones congénitas diagnosticadas por ecografía prenatal en el Hospital Materno Infantil Germán Urquidi, enero 2020 a diciembre de 2021. Conclusión: Es fundamental que las pacientes realicen de forma temprana el control prenatal para ser derivadas de manera oportuna a un centro de referencia en medicina materno fetal para el diagnóstico prenatal, de tal forma que permita un manejo por un equipo multidisciplinario que sea capaz de ofrecer consejería apropiada, evaluar la necesidad de mayor estudio, opciones de manejo y necesidad de seguimiento de la paciente para así coordinar el momento, lugar y vía de parto para un óptimo manejo postnatal.

8.
Int J Educ Dev ; 100: 102805, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37235200

RESUMO

The COVID-19 pandemic produced the most significant disruption in education in history. More than 190 countries suspended in-person instruction, affecting an estimated 1.6 billion students. The reopening of schools has been unequal. Schools in more affluent areas reopened sooner than poorer ones, exacerbating preexisting inequalities. There is limited research about the reopening processes in Latin America, where schools were closed for extended periods. Using a rich administrative dataset, we investigate the gaps in the resumption of in-person instruction in Chilean schools across socioeconomic groups in the fall of 2021. Schools with lower socioeconomic status were significantly less likely to offer in-person instruction. Disparities in reopening decisions were associated with administrative factors rather than economic or local epidemiological conditions.

9.
Foods ; 12(9)2023 Apr 28.
Artigo em Inglês | MEDLINE | ID: mdl-37174367

RESUMO

Numerous agricultural regions face the daunting task of providing high-quality fresh fruits and vegetables to increasingly competitive markets [...].

10.
Int. j. morphol ; 41(2): 618-624, abr. 2023. tab
Artigo em Espanhol | LILACS | ID: biblio-1440303

RESUMO

El conocimiento de la relación entre el seno maxilar y los ápices de los dientes posterosuperiores es fundamental para evitar complicaciones frente a distintos tratamientos. Estudio descriptivo de corte transversal, con muestra por conveniencia de 383 imágenes de raíces de dientes posterosuperiores obtenidas por medio de tomografía computarizada de haz cónico (TCHC) de un centro radiológico en Viña del Mar, Chile. Cada raíz fue clasificada según su relación vertical con el seno en 4 categorías (0: ápice no se encuentra en contacto con contorno inferior del seno; 1: ápice en contacto con seno; 2: ápice lateralmente al seno; 3: ápice se protruye en seno). Además se midió su distancia en mm. Los datos fueron analizados con estadística descriptivas. El diente más lejano al seno maxilar fue el primer premolar superior (4.2 mm), seguido por el segundo premolar superior (1 mm). En el primer molar superior la raíz más lejana fue la mesio-vestibular (MV) 1mm, seguida por la raíz disto-vestibular (DV) 0.6mm y la raíz palatina (P) -1mm. En el segundo molar superior la raíz más lejana fue P 0.4mm, luego la DV 0.3mm, y MV -0,11mm. En cuanto a las categorías, se observó que la mayoría de las raíces se encuentran alejadas del seno siendo la raíz P del primer molar superior y la raíz MV del segundo molar superior las que se encuentran mayormente protruidas (42 % y 26 % respectivamente). El primer premolar es el diente posterosuperior que se encuentra más alejado del seno maxilar y a medida que se avanza hacia posterior hay tendencia a disminuir la distancia entre los ápices y el seno maxilar.


SUMMARY: Knowledge of the relationship between the maxillary sinus and the apices of the upper posterior teeth is crucial to avoid complications when considering different treatments. A descriptive cross-sectional study was carried out, with a convenience sample of 383 images of upper posterior teeth roots, obtained by means of cone beam computed tomography (CBCT) from a radiological center in Viña del Mar, Chile. Each root was classified according to its vertical relationship with the sinus into 4 categories (0: apex is not in contact with the lower contour of the sinus; 1: apex is in contact with the sinus; 2: apex laterally to the sinus; 3: apex protrudes in sinus). In addition, its distance was measured in mm. The data were analyzed with descriptive statistics. The tooth farthest from the maxillary sinus was the maxillary first premolar (4.2 mm), followed by the maxillary second premolar (1 mm). In the upper first molar, the most distant root was the mesiobuccal (MV) 1mm, followed by the distobuccal root (DV) 0.6mm and the palatal root (P) -1mm. In the upper second molar, the furthest root was P 0.4mm, then DV 0.3mm, and MV -0.11mm. In reference to the categories, it was observed that most of the roots are far from the sinus, with the P root of the first upper molar and the MV root of the second upper molar being the most protruding (42 % and 26 % respectively). The first premolar is the posterior maxillary tooth that is furthest from the maxillary sinus and as one advances posteriorly there is a tendency to decrease the distance between the apices and the maxillary sinus.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Ápice Dentário/diagnóstico por imagem , Tomografia Computadorizada de Feixe Cônico , Seio Maxilar/diagnóstico por imagem , Estudos Transversais , Ápice Dentário/anatomia & histologia , Seio Maxilar/anatomia & histologia
11.
Foods ; 12(6)2023 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-36981124

RESUMO

In this study, the feasibility of storing Marmande tomatoes (Solanum lycopersicum, cv Rojito) under hypobaric conditions was evaluated. The fruits were sorted into four lots of 72 fruits each. One lot was considered as a control, and the fruits were kept in the open box, while the fruits of the rest of the three remaining lots were enclosed in airtight containers and subjected to 101, 75 and 50 Kpa, respectively. Control fruits and airtight containers were kept at room temperature, and every three days from the beginning of the experiment the following main quality parameters were analysed: ethylene production rate, firmness, colour, total solids content, ascorbic acid, total phenolics and pigments, as well as a sensory analysis carried out by panellists. The results show that sub-atmospheric storage led a reduction in ethylene production, which was associated with a delay in ripening. The differences in the evolution of pigments were very significant, while a large degradation of chlorophylls was observed in the control fruits and in those kept at 101 kPa, in the fruits kept at 75 kPa and 50 kPa the degradation was much slower. In relation to carotenoid pigments, it was observed that sub-atmospheric treatments delayed their appearance compared to control and 101 kPa fruits. In relation to other quality parameters, it was found that control fruit and fruit held at 101 kPa softened more rapidly than fruit under sub-atmospheric conditions, whose loss of firmness was more gradual with differences found only at 9 and 12 days of storage with respect to fruit firmness at harvest. The appearance of these fruits was evaluated with the same score as at the time of harvesting, during 9 of the 12 days of the experiment, then a positive effect of sub-atmospheric treatments was also found in the sensory analysis. The results suggest that sub-atmospheric storage could be a suitable method of increasing the shelf-life of fruits.

12.
Acta Neuropathol Commun ; 11(1): 31, 2023 02 28.
Artigo em Inglês | MEDLINE | ID: mdl-36855152

RESUMO

Microglia are brain-resident myeloid cells and play a major role in the innate immune responses of the CNS and the pathogenesis of Alzheimer's disease (AD). However, the contribution of nonparenchymal or brain-infiltrated myeloid cells to disease progression remains to be demonstrated. Here, we show that monocyte-derived cells (MDC) invade brain parenchyma in advanced stages of AD continuum using transcriptional analysis and immunohistochemical characterization in post-mortem human hippocampus. Our findings demonstrated that a high proportion (60%) of demented Braak V-VI individuals was associated with up-regulation of genes rarely expressed by microglial cells and abundant in monocytes, among which stands the membrane-bound scavenger receptor for haptoglobin/hemoglobin complexes or Cd163. These Cd163-positive MDC invaded the hippocampal parenchyma, acquired a microglial-like morphology, and were located in close proximity to blood vessels. Moreover, and most interesting, these invading monocytes infiltrated the nearby amyloid plaques contributing to plaque-associated myeloid cell heterogeneity. However, in aged-matched control individuals with hippocampal amyloid pathology, no signs of MDC brain infiltration or plaque invasion were found. The previously reported microglial degeneration/dysfunction in AD hippocampus could be a key pathological factor inducing MDC recruitment. Our data suggest a clear association between MDC infiltration and endothelial activation which in turn may contribute to damage of the blood brain barrier integrity. The recruitment of monocytes could be a consequence rather than the cause of the severity of the disease. Whether monocyte infiltration is beneficial or detrimental to AD pathology remains to be fully elucidated. These findings open the opportunity to design targeted therapies, not only for microglia but also for the peripheral immune cell population to modulate amyloid pathology and provide a better understanding of the immunological mechanisms underlying the progression of AD.


Assuntos
Doença de Alzheimer , Monócitos , Humanos , Idoso , Placa Amiloide , Encéfalo , Hipocampo , Proteínas Amiloidogênicas
13.
Educ Inf Technol (Dordr) ; : 1-47, 2023 Jan 23.
Artigo em Inglês | MEDLINE | ID: mdl-36714447

RESUMO

School dropout is a structural problem which permanently penalizes students and society in areas such as low qualification jobs, higher poverty levels and lower life expectancy, lower pensions, and higher economic burden for governments. Given these high consequences and the surge of the problem due to COVID-19 pandemic, in this paper we propose a methodology to design, develop, and evaluate a machine learning model for predicting dropout in school systems. In this methodology, we introduce necessary steps to develop a robust model to estimate the individual risk of each student to drop out of school. As advancement from previous research, this proposal focuses on analyzing individual trajectories of students, incorporating the student situation at school, family, among other levels, changes, and accumulation of events to predict dropout. Following the methodology, we create a model for the Chilean case based on data available mostly through administrative data from the educational system, and according to known factors associated with school dropout. Our results are better than those from previous research with a relevant sample size, with a predictive capability 20% higher for the actual dropout cases. Also, in contrast to previous work, the including non-individual dimensions results in a substantive contribution to the prediction of leaving school. We also illustrate applications of the model for Chilean case to support public policy decision making such as profiling schools for qualitative studies of pedagogic practices, profiling students' dropout trajectories and simulating scenarios.

14.
Rev Esp Enferm Dig ; 115(9): 524-525, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-36454080

RESUMO

Intraluminal erosion of adjustable and non adjustable gastric bands generally occurs years after placement. Different endoscopic techniques have been described for the management of bands that erode the gastric wall, using endoscopic scissors, rigid endoscopic guides wire coupled to a mechanical lithotripter or even less frequently used devices such as the Gastric Band Cutter System to cut it. We present a clinical case in which we used a lithotripsy laser probe to break the band with great effectiveness without complications.


Assuntos
Gastroplastia , Litotripsia a Laser , Litotripsia , Obesidade Mórbida , Úlcera Gástrica , Humanos , Gastroplastia/efeitos adversos , Gastroplastia/métodos , Obesidade Mórbida/cirurgia , Remoção de Dispositivo
15.
Rev. Soc. Esp. Dolor ; 30(3): 168-177, 2023. ilus, tab, graf
Artigo em Espanhol | IBECS | ID: ibc-228921

RESUMO

Objetivo: Determinar la efectividad clínica de adicionar el ejercicio de elongación de “estiramiento acostado” a un programa de ejercicios específicos en pacientes con síndrome de pinzamiento subacromial (SPSA). Diseño: Estudio clínico aleatorizado ciego simple. Método: Se reclutaron en forma prospectiva 64 pacientes con diagnóstico clínico e imagenológico de SPSA, quienes fueron asignados a dos grupos al azar. El grupo control (n = 32) recibió un programa de ejercicios de 12 semanas, el grupo de intervención (n = 32) recibió el mismo programa más un ejercicio de elongación de la cápsula posterior. Ambos grupos fueron evaluados al inicio y al finalizar el tratamiento. La medida de resultado primaria fue la función del hombro con el cuestionario Constant-Murley, las medidas de resultado secundarias fueron la función de la extremidad superior con el cuestionario DASH y el dolor en reposo y al movimiento con la escala visual analógica (EVA).Resultados: Todos los pacientes completaron el estudio. Al finalizar el tratamiento el cuestionario Constant-Murley mostró una diferencia de 3 puntos (p = 0.864) y el cuestionario DASH una diferencia fue de 2 puntos (p = 0.941), ambas diferencias son a favor del grupo de intervención, pero no son ni clínica ni estadísticamente significativas. Para la EVA en reposo la diferencia fue de 0,2 cm (p = 0,096) y la EVA al movimiento fue de 0,4 cm (p = 0,378), en ambas la diferencia en la reducción del dolor fue mayor en el grupo control. Conclusión: A corto plazo, adicionar el ejercicio de “estiramiento acostado” no proporciona un beneficio clínico ni estadísticamente significativo con respecto a la mejora funcional o la reducción del dolor en pacientes con SPSA.(AU)


Objective: To determine the clinical effectiveness of adding the exercise of “sleep-stretch” to a specific exercise program in patients with subacromial impingement syndrome (SIS). Design: Randomized controlled trial, single-blinded. Methods: Sixty-four patients with clinical and imagenologic diagnosis of SIS were prospectively recruited, who were randomly allocated to two groups. The control group (n = 32) received a 12-week exercise program, and intervention group (n = 32) received the same program plus stretching of the posterior capsule. Both groups were assessed at baseline and at the end of the treatment. The primary outcome measure was shoulder function assessed with Constant-Murley questionnaire. Secondary outcomes measures were upper limb function assessed with the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, and pain at rest and movement with visual analog scale (VAS). Results: All patients completed the trial. At the end of the treatment, Constant-Murley questionnaire showed a difference of 3 points (p = 0.864), and the DASH questionnaire a difference was 2 points (p = 0.941), both differences were in favor of the intervention group, but they are neither clinically or statistically significant. For the VAS at rest the difference was 0.2 cm (p = 0.096) and the VAS at movement was 0.4 cm (p = 0.378), both differences in pain reduction was greater in the control group.Conclusion: In the short term, the addition of a “sleep-stretch” exercise does not provide a clinically or statistically significant benefit with respect to functional improvement or pain reduction in patients with SIS.(AU)


Assuntos
Humanos , Masculino , Feminino , Síndrome de Colisão do Ombro/tratamento farmacológico , Dor Musculoesquelética/tratamento farmacológico , Terapia por Exercício , Manejo da Dor/métodos , Estudos de Casos e Controles , Inquéritos e Questionários , Dor/classificação , Dor/tratamento farmacológico
17.
J Clin Med ; 11(13)2022 Jun 22.
Artigo em Inglês | MEDLINE | ID: mdl-35806897

RESUMO

Colorectal cancer (CRC) is the third most common cancer and the second cause of cancer death worldwide. Several factors have been postulated to be involved in CRC pathophysiology, including heritable and environmental factors, which are the latest to be closely associated with nutritional habits, physical activity, obesity, and the gut microbiota. The latter may also play a key role in CRC prognosis and derived complications in patients undergoing surgery. This is a single-center, open, controlled, randomized clinical trial, in patients with scheduled surgical intervention for CRC. The primary objective is to assess whether a pre-surgical nutritional intervention, based on a high-fiber diet rich in polyunsaturated fatty acids (PUFAs), can reduce disturbances of the gut microbiota composition and, consequently, the rate of post-surgical complications in patients with CRC. Patients will be randomized in a 1:1 ratio after receiving a diagnosis of CRC. In the control arm, patients will receive standard nutritional recommendations, while patients in the intervention arm will be advised to follow a high-fiber diet rich in PUFAs before surgery. Participants will be followed up for one year to evaluate the overall rate of postsurgical complications, recurrences of CRC, response to adjuvant therapy, and overall/disease-free survival.

18.
Int J Surg ; 104: 106751, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35803517

RESUMO

Colorectal cancer (CRC) is the third most frequent malignancy and the second cause of cancer death worldwide. Several factors have been postulated to be involved in CRC pathophysiology, including physical inactivity, unhealthy dietary habits, obesity, and the gut microbiota. Emerging data suggest that the microbiome may play a key role in CRC prognosis and derived complications in patients undergoing colorectal surgery. On the other hand, dietary intervention has been demonstrated to be able to induce significant changes in the gut microbiota and related metabolites in different conditions; therefore, the manipulation of gut microbiota through dietary intervention may constitute a useful approach to improve perioperative dysbiosis and post-surgical outcomes in patients with CRC. In this article, we review the role of the gut microbiota in CRC surgery complications and the potential therapeutic modulation of gut microbiome through nutritional intervention in patients with CRC undergoing surgery.


Assuntos
Neoplasias Colorretais , Microbioma Gastrointestinal , Dieta , Humanos
19.
EJHaem ; 3(2): 362-370, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35846050

RESUMO

There is limited understanding of the inter-compartmental progression and treatment outcomes of primary central nervous system lymphoma (PCNSL). In this multicenter retrospective cohort study on 234 patients with PCNSL (median age: 62.5 years [18-92]; median follow-up 35 months [0.1-237.0]) from 2000 till 2018 were divided into group 1 (ocular, 44 patients): 1A and 1B without and with CNS progression and group 2 (CNS, 190 patients): 2A and 2B without and with ocular progression, respectively. In group 1 (44 patients), 33 patients received local treatment, and 11 patients received systemic treatment. In group 2 (15 patients), six patients received combination treatment, while seven patients received only systemic treatment. A complete response was observed in 19 (43%) and 91 (48%) patients in groups 1 and 2, respectively. The 2-year progression-free survival (PFS) was 35% (95% CI: 0.23, 0.54) and 56% (95% CI: 0.49, 0.63) for groups 1 and 2, respectively (p < 0.0001). Age < 60 years was significantly associated with longer PFS (median PFS 48 vs. 24 months, p = 0.01). The overall survival (OS) at 2-year was similar among groups 1 and 2 (83% and 67%), respectively (p = 0.06). Thus, Initial compartment of involvement does not influence local response rate or OS.

20.
Sensors (Basel) ; 22(11)2022 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-35684734

RESUMO

Pisum sativum L. ssp. arvense, is colloquially called tirabeque or mangetout because it is eaten whole; its pods are recognized as a delicatessen in cooking due to its crunch on the palate and high sweetness. Furthermore, this legume is an important source of protein and antioxidant compounds. Quality control in this species requires the analysis of a large number of samples using costly and laborious conventional methods. For this reason, a non-chemical and rapid technique as near-infrared reflectance spectroscopy (NIRS) was explored to determine its physicochemical quality (color, firmness, total soluble solids, pH, total polyphenols, ascorbic acid and protein content). Pod samples from different cultivars and grown under different fertigation treatments were added to the NIRS analysis to increase spectral and chemical variability in the calibration set. Modified partial least squares regression was used for obtaining the calibration models of these parameters. The coefficients of determination in the external validation ranged from 0.50 to 0.88. The RPD (standard deviation to standard error of prediction ratio) and RER (standard deviation to range) were variable for quality parameters and showed values that were characteristic of equations suitable for quantitative prediction and screening purposes, except for the total soluble solid calibration model.


Assuntos
Pisum sativum , Espectroscopia de Luz Próxima ao Infravermelho , Calibragem , Análise dos Mínimos Quadrados , Espectroscopia de Luz Próxima ao Infravermelho/métodos
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