RESUMO
Alzheimer's disease (AD) is a physical illness, which damages a person's brain; it is the most common cause of dementia. AD can be characterized by the formation of amyloid-beta (Aß) deposits. They exhibit diverse morphologies that range from diffuse to dense-core plaques. Most of the histological images cannot be described precisely by traditional geometry or methods. Therefore, this study aims to employ multifractal geometry in assessing and classifying amyloid plaque morphologies. The classification process is based on extracting the most descriptive features related to the amyloid-beta (Aß) deposits using the Naive Bayes classifier. To eliminate the less important features, the Random Forest algorithm has been used. The proposed methodology has achieved an accuracy of 99%, sensitivity of 100%, and specificity of 98.5%. This study employed a new dataset that had not been widely used before.
Assuntos
Doença de Alzheimer , Humanos , Doença de Alzheimer/diagnóstico por imagem , Doença de Alzheimer/patologia , Placa Amiloide/patologia , Algoritmo Florestas Aleatórias , Teorema de Bayes , Peptídeos beta-Amiloides/metabolismo , Encéfalo/metabolismoRESUMO
Alzheimer's Disease (AD) is considered one of the most diseases that much prevalent among elderly people all over the world. AD is an incurable neurodegenerative disease affecting cognitive functions and were characterized by progressive and collective functions deteriorating. Remarkably, early detection of AD is essential for the development of new and invented treatment strategies. As Dementia causes irreversible damage to the brain neurons and leads to changes in its structure that can be described adequately within the framework of multifractals. Hence, the present work focus on developing a promising and efficient computing technique to pre-process and classify the AD disease especially in the early stages using multifractal geometry to extract the most changeable features due to AD. Then, A machine learning classification algorithm (K-Nearest Neighbor) has been implemented in order to classify and detect the main four early stages of AD. Two datasets have been used to ensure the validation of the proposed methodology. The proposed technique has achieved 99.4% accuracy and 100% sensitivity. The comparative results show that the proposed classification technique outperforms is recent techniques in terms of performance measures.
Assuntos
Doença de Alzheimer , Disfunção Cognitiva , Doenças Neurodegenerativas , Humanos , Idoso , Doença de Alzheimer/diagnóstico , Imageamento por Ressonância Magnética/métodos , Algoritmos , Encéfalo , Disfunção Cognitiva/diagnósticoRESUMO
OBJECTIVE: To evaluate the effect of varying ferrule height and distribution on the fatigue resistance and fracture strength of endodontically treated premolars. MATERIALS AND METHOD: Thirty-two extracted human premolars were endodontically treated and prepared to receive all-ceramic crowns. Teeth were randomly divided into two groups. The occluso-cervical height was reduced to 2 mm and 4 mm for the 1st and 2nd groups, respectively. According to the ferrule distribution, samples in each group were randomly divided into two subgroups with inadequate ferrule on 1 or 2 proximal walls, respectively. Coronal tooth structure was built-up to 4 mm using a core build-up material retained by a fiber post. The CEREC system (Sirona) was used to design and mill lithium-disilicate crowns. All posts and crowns were cemented to their respective teeth using self-adhesive universal resin cement. All crowns were subjected to cyclic loading in a universal testing machine (Instron) (20-100N, 100,000 cycles, 20Hz). After fatigue, crowns were loaded to fracture. Fracture load data were analyzed using two-way ANOVA at α = 0.05. RESULTS: All crowns passed the fatigue testing without any signs of fracture or crack. Two-way ANOVA revealed a statistically significant effect of the number of missing walls (P < 0.05) on the fracture load, but not the ferrule height or the interaction terms. Samples with one missing wall showed higher fracture load in comparison to samples with two missing walls. CONCLUSION: The number of missing walls, not the ferrule height, has a significant effect on the fracture load of the lithium-disilicate crowns restoring endodontically treated premolars.
Assuntos
Técnica para Retentor Intrarradicular , Fraturas dos Dentes , Dente não Vital , Dente Pré-Molar , Resinas Compostas , Coroas , Falha de Restauração Dentária , Análise do Estresse Dentário , HumanosRESUMO
We present a supercomputer-driven pipeline for in silico drug discovery using enhanced sampling molecular dynamics (MD) and ensemble docking. Ensemble docking makes use of MD results by docking compound databases into representative protein binding-site conformations, thus taking into account the dynamic properties of the binding sites. We also describe preliminary results obtained for 24 systems involving eight proteins of the proteome of SARS-CoV-2. The MD involves temperature replica exchange enhanced sampling, making use of massively parallel supercomputing to quickly sample the configurational space of protein drug targets. Using the Summit supercomputer at the Oak Ridge National Laboratory, more than 1 ms of enhanced sampling MD can be generated per day. We have ensemble docked repurposing databases to 10 configurations of each of the 24 SARS-CoV-2 systems using AutoDock Vina. Comparison to experiment demonstrates remarkably high hit rates for the top scoring tranches of compounds identified by our ensemble approach. We also demonstrate that, using Autodock-GPU on Summit, it is possible to perform exhaustive docking of one billion compounds in under 24 h. Finally, we discuss preliminary results and planned improvements to the pipeline, including the use of quantum mechanical (QM), machine learning, and artificial intelligence (AI) methods to cluster MD trajectories and rescore docking poses.
Assuntos
Antivirais/química , Tratamento Farmacológico da COVID-19 , SARS-CoV-2/efeitos dos fármacos , Proteínas não Estruturais Virais/química , Inteligência Artificial , Sítios de Ligação , Simulação por Computador , Bases de Dados de Compostos Químicos , Desenho de Fármacos , Avaliação Pré-Clínica de Medicamentos , Humanos , Simulação de Acoplamento Molecular , Conformação Proteica , Glicoproteína da Espícula de Coronavírus/química , Relação Estrutura-AtividadeRESUMO
We present a supercomputer-driven pipeline for in-silico drug discovery using enhanced sampling molecular dynamics (MD) and ensemble docking. We also describe preliminary results obtained for 23 systems involving eight protein targets of the proteome of SARS CoV-2. THe MD performed is temperature replica-exchange enhanced sampling, making use of the massively parallel supercomputing on the SUMMIT supercomputer at Oak Ridge National Laboratory, with which more than 1ms of enhanced sampling MD can be generated per day. We have ensemble docked repurposing databases to ten configurations of each of the 23 SARS CoV-2 systems using AutoDock Vina. We also demonstrate that using Autodock-GPU on SUMMIT, it is possible to perform exhaustive docking of one billion compounds in under 24 hours. Finally, we discuss preliminary results and planned improvements to the pipeline, including the use of quantum mechanical (QM), machine learning, and AI methods to cluster MD trajectories and rescore docking poses.
RESUMO
Headache is a common reason to visit the emergency department (ED). Tension-type headache (TTH) is the commonest headache. The diagnosis of TTH implies a mild condition, with no need for special tests. We evaluated the use of the International Classification of Headache Disorders (ICHD) criteria for TTH in the ED. We performed a cross-sectional study including all ED patients with a definite TTH diagnosis in their discharge report for 2.5 years. We evaluated whether the ICHD criteria for TTH were referenced and met. We analysed discrepancies concerning anamnesis or prior history and reclassified patients. A total of 211 out of 2132 patients fulfilled the criteria (9.9%). Only five patients fulfilled TTH criteria. Criteria A-D were referenced in 60-84% of patients and met in 16-74% of these patients. Anamnesis was discrepant in 87.5% as was prior history in 20.8%. After re-reclassification, 21 patients fulfilled the criteria for TTH (five) or probable TTH (16). In 106 patients, another headache was diagnosed, with migraine in 40 (18.9%), secondary headache in 64 (30.3%), and a life-threatening disorder in 13 (6.1%). In our sample, TTH was overdiagnosed. Only a minority of patients fulfilled the ICHD criteria. Inconsistencies in prior medical history or anamnesis were frequent.
Assuntos
Cefaleia do Tipo Tensional/diagnóstico , Adulto , Estudos Transversais , Erros de Diagnóstico , Serviço Hospitalar de Emergência , Feminino , Humanos , Classificação Internacional de Doenças , Masculino , Pessoa de Meia-IdadeRESUMO
BACKGROUND: There is wide agreement nowadays that a clinical varicocoele should be ligated to treat male factor infertility. However, the significance of testicular artery preservation in patients with severe oligozoospermia has not been addressed before. OBJECTIVES: To assess the outcome of varicocelectomy in infertile men with severe oligozoospermia and clinical varicocoeles and to compare internal spermatic artery preservation vs. artery ligation. MATERIALS AND METHODS: This prospective randomized study included 302 infertile patients with severe oligozoospermia and clinical (grade II/III) varicocoeles. Patients were randomized into two groups: group A (150 patients) underwent artery-preserving varicocelectomy (APV) and group B (152 patients) underwent artery-ligating varicocelectomy (ALV). The primary outcome was to assess the changes in sperm density and motility at 3 and 6 months postoperatively in both groups. The secondary outcome was to compare the natural pregnancy rate at 1-year of follow-up. Univariate and multivariate analyses were performed to determine factors affecting pregnancy rate. RESULTS: In both groups, there was a statistically significant improvement in sperm density and motility at 3 and 6 months postoperatively. In group A, there was a greater improvement in sperm density (p < 0.001) and motility (p < 0.001) compared to group B. At 1-year follow-up, overall 35.1% achieved a natural pregnancy. Group A achieved a significantly higher natural pregnancy rate (40% vs. 30%, p value = 0.03) compared to group B. Smaller testicular volume and ALV were the independent predictors of lower pregnancy rate ((HR = 3.2, 95% CI 1.2-8.3, p = 0.01) and (HR = 3.2, 95% CI 1.4-7.1, p = 0.003), respectively). CONCLUSION: In men with severe oligozoospermia and a clinical varicocoele, APV results in improved outcomes as compared to ALV with respect to semen parameters and natural pregnancy rates. Therefore, all attempts should be made to preserve internal spermatic arteries (ISA) during varicocelectomy in men with severe oligozoospermia.
Assuntos
Oligospermia/cirurgia , Varicocele/cirurgia , Procedimentos Cirúrgicos Vasculares/métodos , Adulto , Humanos , Masculino , Resultado do TratamentoRESUMO
BACKGROUND: Single nucleotide polymorphisms (SNPs) of Toll-like receptors (TLRs) are linked with functional modification of cytokine responses. In chronic hepatitis C virus (HCV) infection, studies of TLR polymorphisms have primarily targeted receptor pathways implicated in viral immune responses. We hypothesized that one or more variant(s) of TLR3, TLR7 and TLR8 are associated with different outcomes of HCV infection. MATERIALS & METHODS: A total of 3368 subjects from 850 families were recruited and divided into three main groups categorized as chronic HCV CHC spontaneous viral clearance (SVC), and controls. All individuals were genotyped for three SNPs for TLR3, two SNPs for TLR7, and two SNPs for TLR8 using allelic discrimination real-time PCR. RESULTS: Carriage of the C allele in three SNPs of TLR3 (rs3775290, rs3775291, and rs5743312), the C allele in TLR7 (rs3853839) in females only, and the C allele in TLR8 (rs3764879) in males only were significantly higher in SVC group than CHC group (P < 0.001), while carriage of the T allele in TLR7 (rs179008) in females only and the A allele in TLR8 (rs3764880) in both males and females were significantly higher in CHC infection more than SVC group (P < 0.001). CONCLUSION: The C allele is protective of HCV in TLR3, TLR7 (rs3853839) in females only, and TLR8 (rs3764879) in males only, while risk of infection is linked to the T allele in TLR7 (rs179008) in females only and the A allele in TLR8 (rs3764880) in both sexes.
Assuntos
Hepatite C Crônica/genética , Receptor 3 Toll-Like/genética , Receptor 7 Toll-Like/genética , Receptor 8 Toll-Like/genética , Adulto , Alelos , Feminino , Estudos de Associação Genética , Predisposição Genética para Doença , Genótipo , Hepacivirus/genética , Hepacivirus/patogenicidade , Hepatite C Crônica/patologia , Hepatite C Crônica/virologia , Humanos , Masculino , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único/genética , Fatores de RiscoRESUMO
OBJECTIVES: To evaluate the impact of radical cystectomy and urinary diversion on female sexual function. MATERIALS AND METHODS: A Medline search was conducted according to the PRISMA statement for all English full-text articles published between 1980 and 2016 and assessing female sexual function post radical cystectomy and urinary diversion. Eligible studies were subjected to critical analysis and revision. The primary outcomes were the reporting methods for female sexual dysfunction (FSD), manifestations of FSD, and factors associated with FSD, postoperative recoverability of FSD, and awareness level regarding FSD. RESULTS: From the resulting 117 articles, 11 studies were finally included in our systematic review, with a total of 361 women. Loss of sexual desire and orgasm disorders were the most frequently reported (49% and 39%). Dyspareunia and vaginal lubrication disorders were reported in 25% and 9.5%, respectively. The incidence of sexual dysfunction was 10% in 30 patients receiving genital- or nerve-sparing cystectomy vs. 59% receiving conventional cystectomy. CONCLUSION: Although female sexual function is an important predictor of health-related quality of life post radical cystectomy and urinary diversion, the available literature is not enough to provide proper information for surgeons and patients.
Assuntos
Cistectomia/efeitos adversos , Complicações Pós-Operatórias/epidemiologia , Disfunções Sexuais Fisiológicas/epidemiologia , Disfunções Sexuais Psicogênicas/epidemiologia , Derivação Urinária/efeitos adversos , Adulto , Idoso , Dispareunia/epidemiologia , Feminino , Humanos , MEDLINE , Pessoa de Meia-Idade , Qualidade de VidaRESUMO
Due to its potency to utilize in enormous applications, preparation of nanogold is of interest. Moreover, getting of highly dispersed nanogold with small size is extremely needful in specific fields. Herein, Au nanocolloid was prepared using alkali catalyzed pectin biopolymer. Pectin was concurrently used as reductant for Au ions and stabilizer for the produced Au nanoparticles (AuNPs). Reducing sugars were evaluated in the colloidal solution reflecting the role alkali in catalytic degradation of pectin to produce much powerful reducing moieties. The obtained Au nanocolloid was monitored via changing in color, UV-visible spectral and transmission electron microscopy. Using of NaOH as strong alkali achieving rapid rate of degradation reaction, resulted in 0.45g/L reducing sugars from 0.2g/L pectin which produced AuNPs with mean size of 6.5nm. In case of Na2CO3 which attained slow degradation rate led to, slightly low reducing sugar content (0.41g/L), fabricated comparatively size of AuNPs (7.5nm). In both cases, well distributed AuNPs was obtained with suitable stabilization up to 5 months and Na2CO3 exhibited higher stability. The current successful method used to produce small sized AuNPs with high dispersion is an innovative, one-step, easily, costless, energy saving and eco-friendly method.
Assuntos
Ouro/química , Nanopartículas Metálicas/química , Pectinas/químicaRESUMO
Nowadays, functional clothes are employed for human body protection in addition to be fashionable clothes. Hence functionalization of clothes increases the attention of scientists and business. In the current study, poly-functional cotton fabric was carried out by instantly deposition of AgNPs using two solventless techniques namely; sorption and padding. Sorption technique was exhibited extremely high efficiency than padding one by ca. 10 times. By using the same concentrations of AgNO3, Ag content was ranged 69.3-6094.8 mg/kg and 33.8-609.3 mg/kg for sorption and padding, respectively. After AgNPs deposition, fabrics color was turned to gray-reddish yellow. By applying 5912.3 mgAg/kg fabric, bacterial reduction and UPF value were reached 99% and 12.59. Bacterial reduction and UPF were lessened to 90% and 10.19 after 20 washings. These findings proved that the direct AgNPs deposition into cotton using solventless/sorption technique is applicable in manufacturing of antibacterial/UV resistant fabrics with acquired decorative color.
Assuntos
Fibra de Algodão , Nanopartículas Metálicas , Prata , Têxteis , Adsorção , Antibacterianos/química , Cor , Fenômenos Mecânicos , Nanopartículas Metálicas/ultraestrutura , Raios Ultravioleta , Difração de Raios XRESUMO
Medical cotton is usually used to clean skin, pack wounds and in other surgical tasks. Such important usages make imparting the antibacterial property to medical cotton is so essential research. The current research focuses on functionalization of medical cotton by direct incorporation of silver nanoparticles (AgNPs) in two-step process namely, pre-alkalization followed by sorption. Decorative color and antibacterial action were accomplished for medical cotton after in situ incorporation of AgNPs without using any other external reducing agent. AgNPs were produced due to the reduction action of alcoholic and aldehydic groups of cotton's skeletal blocks. Cotton fibers were acquired a decorative color attributed to surface plasmon resonance of AgNPs. The treated cotton was characterized by using electron microscope. Results showed that Ag(0) with size distribution of 0-160 nm was formed in the cotton fibers and their size majority (70%) was less than 80 nm. The reduction of Ag(+) to Ag(0) was confirmed by measuring the carboxylic and aldehydic contents. The treated cotton exhibited excellent antibacterial action at low silver contents. The absorbency of cotton was not affected by treatment. The produced medical cotton could be used to safe cleaning of wounds without getting any microbial infections.
Assuntos
Fibra de Algodão , Nanopartículas Metálicas , Prata , Anti-Infecciosos , Análise Espectral/métodosRESUMO
The main objective of the current research was to successfully employ the reducing and stabilizing features of xanthan gum to synthesize nanosilver, then coating cotton fabrics with the net produced nanosilver in order to obtain finished fabrics valuable in medical applications. Pre-hydrolyzed xanthan gum was used to reduce Ag(+) to Ag(0) in nano size using a simple one-step rapid synthetic route. The reduction step was followed up by measuring the concentration of reducing sugars eliminated in the reaction medium. The optimum concentration of xanthan gum was 3g/L to reduce 1 mmol/L Ag(+), as 2.66 ± 0.4 g/L was the maximum concentration of reducing sugars obtained in the reaction. Transmission microscope images show that the AgNPs are spherical in shape with mean size 9.1 ± 4.8 nm. Cotton fabrics were then coated with the produced AgNPs using pad-dry-cure method. Well dispersed layer from Ag(0) on cotton surface was showed under electron microscope. The biocidal activities of the coated fabrics were tested against Staphylococcus aureus and showed excellent results for antibacterial even after 20 washing cycles. This method has the advantage of not necessitating aggressive conditions such as the presence of organic solvents to produce durable antibacterial cotton fabrics.
Assuntos
Antibacterianos/síntese química , Antibacterianos/farmacologia , Fibra de Algodão , Nanopartículas Metálicas/química , Prata/farmacologia , Carboidratos/análise , Coloides , Cor , Nanopartículas Metálicas/ultraestrutura , Testes de Sensibilidade Microbiana , Tamanho da Partícula , Polissacarídeos Bacterianos/química , Soluções , Espectrometria por Raios X , Espectrofotometria Ultravioleta , Staphylococcus aureus/efeitos dos fármacosRESUMO
A new method to prepare silver nanoparticles was reported. Alginate colloidal solution containing chemically synthesized silver nanoparticles (AgNPs) was investigated regarding the nanoparticles stabilization and possibilities for production of alginate based nanoparticles. The formation of AgNPs has been confirmed by UV-visible spectroscopy and monitoring of reducing sugars in the reaction was carried out. The morphology of synthesized silver nanoparticles was characterized by transmission electron microscopy (TEM). The results showed that the morphology of Ag nanoparticles is spherical and the main size is about 1-4 nm.
Assuntos
Alginatos/química , Nanopartículas Metálicas/química , Prata/química , Ácido Glucurônico/química , Química Verde , Ácidos Hexurônicos/química , Nanopartículas Metálicas/ultraestrutura , Tamanho da PartículaRESUMO
Monodispersed silver nanoparticles capped by pectin were prepared by the reaction of silver nitrate with alkali hydrolyzed pectin at 70 °C for 30 min. Spherical and size-regulated silver nanoparticles were prepared using alkali hydrolyzed pectin as a reducing and particle-stabilizing agent. This approach is facile, effective, rapid, and convenient for the large scale preparation of silver nanoparticles. UV-visible spectral analysis confirmed that the nanoparticles consisted of metallic silver. Transmission electron microscopy (TEM) was used to estimate particle size and size distribution of the produced silver nanoparticles. Transmission electron microscopy and size distribution analysis revealed the presence of spherical silver nanoparticles with a main diameter of 5-10nm and have a narrow size distribution. The concentration of reducing sugars was monitored by using dinitrosalicylic acid. A comprehensive schematic mechanism for the formation of silver nanoparticles using pectin is proposed.
Assuntos
Nanopartículas Metálicas/química , Pectinas/química , Substâncias Redutoras/química , Prata/química , Hidrólise , Nanopartículas Metálicas/ultraestrutura , Microscopia Eletrônica de Transmissão , Nanotecnologia , Tamanho da Partícula , Espectrofotometria UltravioletaRESUMO
In recent years nano-sized particles have been focused on bacteriostasis. We investigated antimicrobial activities by applying AgNPs-alginate composite on cotton fabric, using a simple one-step rapid synthetic route by reduction of silver nitrate using alkali hydrolyzed alginate solution which acts as both reducing and capping agent. FTIR spectra, color coordinates, silver content, silver release percent and SEM images of treated fabric samples confirmed the successful physical deposition of AgNPs-alginate composite on the fabric. The treated fabrics demonstrated an excellent antibacterial activity against the tested bacteria, Escherichia coli, Staphylococcus aureus and Pseudomonas aeruginosa. A slight decrease in the antibacterial feature of the cotton fabrics was observed after successive washings. However, an efficient antibacterial activity still remained on the fabrics.
Assuntos
Alginatos/química , Antibacterianos/química , Antibacterianos/farmacologia , Fibra de Algodão , Nanopartículas Metálicas/química , Nanocompostos/química , Prata/química , Escherichia coli/efeitos dos fármacos , Ácido Glucurônico/química , Ácidos Hexurônicos/química , Pseudomonas aeruginosa/efeitos dos fármacos , Staphylococcus aureus/efeitos dos fármacosRESUMO
An ecological and viable method for coating of cotton fabrics with silver nanoparticles (AgNPs) has been carried out. Nanocoated fabrics were characterized by scanning electron microscopy, energy dispersive X-ray and infrared spectroscopy. Color coordinates and silver release were assessed and the impact of repeated washings was evaluated. Silver contents were measured using atomic absorption spectroscopy and were 109.07 and 97.85 mg/kg for the fabrics treated with 100 ppm of AgNPs in presence and absence of binder respectively. Antibacterial activities of the cotton fabrics coated by AgNPs were evaluated qualitatively and quantatively, and the results explored that, regardless of the concentration of AgNPs used, the biocidability was always higher without washing. However, for all coated fabrics, a sufficient antibacterial action still observed after 20 washings. The results revealed that valuable antibacterial textiles which are required in different medical textile fields could be successfully produced.
Assuntos
Antibacterianos/química , Antibacterianos/farmacologia , Fibra de Algodão , Nanopartículas Metálicas/química , Prata/química , Prata/farmacologia , Cor , Escherichia coli/efeitos dos fármacos , Staphylococcus aureus/efeitos dos fármacosRESUMO
Silver nanoparticles were prepared by using alkali treated maize starch which plays a dual role as reducer for AgNO3 and stabilizer for the produced AgNPs. The redox reaction which takes a place between AgNO3 and alkali treated starch was followed up and controlled in order to obtain spherical shaped silver nanoparticles with mean size 4-6 nm. The redox potentials confirmed the principle role of alkali treatment in increasing the reducibility of starch macromolecules. The measurements of reducing sugars at the end of reaction using dinitrosalicylic acid reagent (DNS) were carried out in order to control the chemical reduction reaction. The UV/Vis spectra show that an absorption peak, occurring due to surface plasmon resonance (SPR), exists at 410 nm, which is characteristic to yellow color of silver nanoparticles solution. The samples have been characterized by transmission electron microscopy (TEM), which reveal the nanonature of the particles.
RESUMO
Green synthesis of nanoparticles that have environmentally acceptable solvent systems and eco-friendly reducing agents is of great importance. The aim of this work was to synthesis of silver nanoparticles (AgNPs) using water soluble polysaccharides extracted from four marine macro-algae, namely, Pterocladia capillacae (Pc), Jania rubins (Jr), Ulva faciata (Uf), and Colpmenia sinusa (Cs) as reducing agents for silver ions as well as stabilizing agents for the synthesized AgNPs. The formed Ag-NPs have been confirmed by UV-Vis spectroscopy, FTIR analysis and TEM. The resultant Ag-NPs colloidal solutions were applied to cotton fabrics in presence and absence of citric acid (CA) or a binder (B). The antimicrobial activity of the treated fabrics was evaluated. The results revealed that the antimicrobial activity depends on type of the fabric treatment, size of the synthesized Ag-NPs and the algal species used for polysaccharides extraction.
Assuntos
Antibacterianos/química , Nanopartículas Metálicas/química , Polissacarídeos/química , Prata/química , Antibacterianos/síntese química , Antibacterianos/farmacologia , Clorófitas/química , Ácido Cítrico/química , Fibra de Algodão , Escherichia coli/efeitos dos fármacos , Phaeophyceae/química , Rodófitas/química , Staphylococcus aureus/efeitos dos fármacos , TêxteisRESUMO
OBJECTIVES: To report on the safety of combing suprapubic fat liposuction, penile suspensory ligament severing, and Z-plasty of penoscrotal webbing for penile lengthening in cases of post-circumcision traumatic short penis in adolescents. METHODS: This prospective study was conducted in 9 male patients with a mean age of 15.6 ± 1.4 years. All patients had a short penis because of traumatic amputation of the glans in 7 patients and both glanular and partial distal corporal loss in 2 patients during circumcision. All were initially treated in childhood by penile skin advancement for phallic coverage. Penile length and circumference were measured pre- and post-operatively, both in the flaccid state at maximal stretch and in the erect state. Operative technique included Z-plasty of penoscrotal web, release of suspensory ligament, and suprapubic fat liposuction. RESULTS: Average functional penile length measured 3 months post-operatively had significantly increased by 18-30 mm (mean: 23 ± 4 mm) in the provoked, erect state. All patients had normally developed penile corpora cavernosa and wide circumference (mean: 11.7 ± 0.2 cm). No post-operative complications occurred in any of the patients. No patients had sexual partners or were sexually active. CONCLUSIONS: The described technique of penile advancement and lengthening can be safely applied to patients with post-circumcision traumatic short penis.