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1.
Cir Cir ; 91(6): 794-797, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38096876

RESUMO

BACKGROUND: Von Meyenburg complexes are benign hamartomatous lesions, they are part of the spectrum of ductal plate malformations. They are rare, reported in 0.35-5.6% of the general population, predominantly in adults, with no clear predilection for sex. OBJECTIVE: To present the clinical characteristics of Von Meyenburg complexes in our region. METHOD: We searched all cases with diagnosis of Von Meyenburg complexes in a period from 2012 to 2022, in our institutions. RESULTS: We identified eight cases, with an average age of 59.25 years, with a predominance of females and with one case associated with gastric carcinoma. CONCLUSIONS: It is important to adequately recognize this entity, since due to its multifocal nature it can easily simulate metastasis, additionally, and its presence does not rule out other synchronous neoplasms.


ANTECEDENTES: Los complejos de Von Meyenburg son lesiones hamartomatosas benignas que forman parte del espectro de las malformaciones de la placa ductal. Son poco frecuentes, se reportan en un 0.35-5.6% de la población general, predominantemente en adultos, sin clara predilección por un sexo. OBJETIVO: Presentar las características clínicas de los complejos de Von Meyenburg en nuestro medio. MÉTODO: Se buscaron todos los casos con diagnóstico de complejos de Von Meyenburg en nuestras instituciones entre 2012 y 2022. RESULTADOS: Identificamos ocho casos, con un promedio de edad de 59.25 años, con predominio por el sexo femenino y con un caso asociado a carcinoma gástrico. CONCLUSIONES: Es importante reconocer y diagnosticar adecuadamente esta afección, ya que por su naturaleza multifocal fácilmente puede simular metástasis, y además su presencia no descarta otros procesos neoplásicos sincrónicos.


Assuntos
Doenças dos Ductos Biliares , Hamartoma , Neoplasias Hepáticas , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Masculino , Diagnóstico Diferencial , Neoplasias Hepáticas/secundário , Hamartoma/complicações , Doenças dos Ductos Biliares/complicações , Doenças dos Ductos Biliares/diagnóstico
2.
Rev Chilena Infectol ; 39(3): 294-303, 2022 Jun.
Artigo em Espanhol | MEDLINE | ID: mdl-36165650

RESUMO

The COVID-19 disease is caused by the SARS-CoV-2 virus and was declared a pandemic by the WHO on March 11, 2020. To date, more than 500 million people have been infected and it has caused over 6 million deaths worldwide. People that belong to the most vulnerable risk groups, such as those at the extremes of life, patients with chronic comorbidities and those with severe immunosuppression, are especially susceptible to developing a severe form of COVID-19 infection and death. Subjects living with HIV, especially those in precarious immunological conditions or those in whom antiretroviral therapy is yet to be started, may be at risk of developing complications related to COVID-19, as observed with other infectious diseases. This review aims to determine the magnitude of the impact of the SARS-CoV-2 virus on people living with HIV in Chile.

3.
Chemosphere ; 303(Pt 3): 135194, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35660056

RESUMO

The long-term monitoring of the cosmogenic 7Be activity concentrations has been used to better understand the influence of large-scale atmospheric circulation dynamics in the troposphere. With an aim, this study analyzes weekly 7Be data from 15 sampling stations in Europe over 2005-2014. We first define peak (or extremely high) events in each station as those activity concentrations above the 90th percentile, and then investigate their temporal and spatial variability. These events are most frequent in the spring and summer seasons, with a notable latitudinal variability in their number. Next, we use back-trajectory cluster analysis to identify the main advection pathways associated with these high concentrations. To achieve this, persistent periods, i.e., sampling periods over which at least 60% of the calculated backward trajectories arriving at a given site correspond to the same airflow pattern, are taken as reference. This method reveals large differences in the association between the airflow patterns observed at different stations in connection with the 7Be peaks. A comparison between stations shows no clear spatial pattern, which suggests a further influence of mesoscale/local physical processes on the surface 7Be activity concentrations. Finally, the main airflow pattern at each sampling site and the associated 7Be peaks, are related to the main teleconnection patterns of large scale and regional climate variability in Europe: North Atlantic Oscillation, Arctic Oscillation, East Atlantic, East Atlantic/Western Russia, Scandinavian pattern and Western Mediterranean Oscillation. The results point out the connection between the negative phases of NAO and We-MO, and the positive phase of EA with the spatial and temporal variability and occurrence of the 7Be peak activity concentrations. These results show a latitudinal division between northern and southern sites, with similar influence of teleconnection patterns, while those located in the central part of Europe present larger variability in the impact of teleconnection patterns.


Assuntos
Atmosfera , Monitoramento Ambiental , Clima , Monitoramento Ambiental/métodos , Europa (Continente) , Estações do Ano
4.
Rev. chil. infectol ; 39(3): 294-303, jun. 2022.
Artigo em Espanhol | LILACS | ID: biblio-1407796

RESUMO

Resumen La enfermedad COVID-19 es una patología de origen infeccioso causada por el virus SARS-CoV-2 y fue declarada pandemia por la OMS el 11 de marzo 2020. A la fecha se registran más de 500 millones de personas infectadas y más de 6 millones de fallecidos en todo el mundo. Las personas que pertenecen a grupos de riesgo más vulnerables, particularmente aquellos que se encuentran en los extremos de la vida, con comorbilidades crónicas o inmunocomprometidas, son especialmente susceptibles a presentar un eventual mayor riesgo de infección, de gravedad y de mortalidad por esta enfermedad. Las personas que viven con VIH, especialmente aquellos en precarias condiciones inmunológicas o aquellas que aún no inician terapia antiretroviral, pueden ser un grupo especialmente susceptible de presentar complicaciones relacionadas a esta y otras enfermedades de origen infeccioso. Con esta revisión se pretende determinar la magnitud del impacto del virus SARS-CoV-2 en personas viviendo con VIH en Chile.


Abstract The COVID-19 disease is caused by the SARS-CoV-2 virus and was declared a pandemic by the WHO on March 11, 2020. To date, more than 500 million people have been infected and it has caused over 6 million deaths worldwide. People that belong to the most vulnerable risk groups, such as those at the extremes of life, patients with chronic comorbidities and those with severe immunosuppression, are especially susceptible to developing a severe form of COVID-19 infection and death. Subjects living with HIV, especially those in precarious immunological conditions or those in whom antiretroviral therapy is yet to be started, may be at risk of developing complications related to COVID-19, as observed with other infectious diseases. This review aims to determine the magnitude of the impact of the SARS-CoV-2 virus on people living with HIV in Chile.


Assuntos
Humanos , Infecções por HIV/epidemiologia , COVID-19/epidemiologia , Infecções por HIV/tratamento farmacológico , Chile/epidemiologia , Saúde Global , Terapia Antirretroviral de Alta Atividade , Vacinas contra COVID-19 , SARS-CoV-2 , COVID-19/prevenção & controle
5.
Clin Transl Oncol ; 23(9): 1955-1960, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33840046

RESUMO

INTRODUCTION: The aim of this study was to analyze the associations between perceived social support and sociodemographic variables on coping strategies. METHODS: A prospective, cross-sectional, multicenter study was conducted in 404 women with resected, non-metastatic breast cancer. Participants completed questionnaires: perceived social support (MSPSS), coping strategies (Mini-MAC), and psychological distress (BSI-18). RESULTS: Sociodemographic factors as age, education, and partnership status were associated with coping strategies. As for maladaptive strategies, hopelessness was more frequent in older people and lower educational level; fatalism in older and single people, and cognitive avoidance was associated with lower educational level. Suppor t from family, friends, and partners was associated with a greater fighting spirit. In contrast, high psychological distress (anxiety and depression) was associated with greater use of maladaptive strategies. CONCLUSION: Young people, a high level of education, having a partner, low psychological distress, and seeking social support were associated with the use of adaptive cancer coping strategies.


Assuntos
Adaptação Psicológica , Neoplasias da Mama/psicologia , Determinantes Sociais da Saúde , Apoio Social , Fatores Sociodemográficos , Fatores Etários , Estudos Transversais , Escolaridade , Feminino , Inquéritos Epidemiológicos , Humanos , Estado Civil , Pessoa de Meia-Idade , Estudos Prospectivos , Angústia Psicológica , Análise de Regressão , Espanha
6.
J Environ Radioact ; 216: 106178, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32056787

RESUMO

The intent of minimizing the impact of the large amount of radioactive material potentially released into the atmosphere in a nuclear event implies preparedness activities. In the early phase and in absence of field observations, countermeasures would largely rely on a previous characterization of the transport and dispersion of radioactive particles and the potential levels of radioactive contamination. This study presents a methodology to estimate the atmospheric transport, dispersion and ground deposition patterns of radioactive particles. The methodology starts identifying the main airflow directions by means of the air mass trajectories calculated by the HYSPLIT model, and, secondly, the dispersion and the ground deposition characteristics associated with each airflow pattern by running the RIMPUFF atmospheric dispersion model. From the basis of these results, different products can be obtained, such as the most probable transport direction, spatial probability distribution of deposition and the geographical probability distribution of deposition above certain predefined threshold. The method is trained on the HYSPLIT trajectories and RIMPUFF simulations during five consecutive years (2012-2016) at the Almaraz Nuclear Power Plant, in Spain. 3644 forward air mass trajectories were calculated (at 00 and 12 UTC, and with duration of 36 h). Eight airflow patterns were identified, and within each pattern, the persistent days, i.e. those days in which trajectories at 00 and 12 UTC grouped into the same airflow pattern, were extracted to simulate the atmospheric dispersion and ground deposition following a hypothetical ISLOCA accident sequence of 35 h. In total, 833 simulations were carried out, in which ground contamination was estimated at cell level on a non-homogeneous geographical grid spacing up to 800 km from Almaraz. The corresponding outcomes show a large variability in the area covered and in deposition values between airflow patterns, which provide comprehensive and oriented information and resources to decision makers to emergency management.


Assuntos
Monitoramento de Radiação , Poluentes Radioativos do Ar , Emergências , Modelos Teóricos , Centrais Nucleares , Liberação Nociva de Radioativos , Espanha
7.
Neotrop Entomol ; 48(6): 949-956, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31463776

RESUMO

To further the use of local parasitoids to control the spotted wing drosophila suzukii (Matsumura) in Mexico, three treatments were implemented by sextuplicate in commercial berry fields of Colima and Jalisco from June 2017 to May 2018: single release of Trichopria drosophilae Perkins (pupal parasitoid), combined release of T. drosophilae + Leptopilina boulardi Barbotin, Carton & Kelner-Pillault (larval parasitoid), and a no release control. Compared with the no release sites, parasitism by T. drosophilae increased 4 and 4.1-fold at the single and combined release sites, respectively, and parasitism of L. boulardi increased 2.8-fold at the sites where it was evaluated. Additionally, it was registered a 50 and 55% reduction of D. suzukii at the sites with single and combined releases, respectively; in other words, supplementing T. drosophilae with L. boulardi provided little benefit compared with the release of T. drosophilae alone. These results indicate that single release of local T. drosophilae is a more cost-effective option to reduce D. suzukii populations, and that such activity can contribute significantly to the phytosanitary management of this invasive pest.


Assuntos
Drosophila/parasitologia , Controle Biológico de Vetores/métodos , Vespas/fisiologia , Animais , México , Pupa/parasitologia , Rubus
8.
Rev Neurol ; 69(4): 145-151, 2019 Aug 16.
Artigo em Espanhol, Inglês | MEDLINE | ID: mdl-31334557

RESUMO

INTRODUCTION: Psychogenic non-epileptic seizures (PNES) are paroxysmal changes in behavior that resemble epileptic seizures, although they have no electrophysiological correlation or clinical evidence of epilepsy. AIM: To compare clinical and sociodemographic characteristics of patients diagnosed with PNES-alone and PNES-and-epilepsy. PATIENTS AND METHODS: A cross-sectional study of consecutive patients diagnosed with PNES in a 20-month period was carried out. A video-EEG was performed in all patients. Socio-demographical, clinical and semiological characteristics were compared between those patients with and without concomitant epilepsy. RESULTS: Sixty-five patients were included, 35 (53.9%) had PNES-alone and 30 (46.1%) had PNES-and-epilepsy. The proportion of women in the study was 70.8%. The median age at seizure onset was 16 years. A late start was recorded in PNES-alone group (23 years) compared to PNES-and-epilepsy group (11 years), however, it was not significant. There was a lower frequency of antiepileptic drugs use in the PNES-alone group compared with the PNES-and-epilepsy group. The most frequent semiological features were the gradual onset of events (69.2%) and the duration longer than two minutes (63.1%). CONCLUSION: The waxing and waning pattern during paroxysmal events suggest a non-epileptic origin. However, it is not uncommon to find patients with concomitant epileptic seizures.


TITLE: Crisis psicogenas no epilepticas y crisis epilepticas: pistas para un diagnostico diferencial. Hallazgos de un estudio colombiano.Introduccion. Las crisis psicogenas no epilepticas (CPNE) son cambios paroxisticos en el comportamiento que se asemejan a las crisis epilepticas, aunque no tienen correlacion electrofisiologica ni evidencia clinica de epilepsia. Objetivo. Comparar las caracteristicas clinicas y sociodemograficas entre pacientes diagnosticados con CPNE, con y sin epilepsia concomitante. Pacientes y metodos. Estudio transversal de pacientes consecutivamente diagnosticados de CPNE durante un periodo de 20 meses. A todos los participantes se les realizo un videoelectroencefalograma (video-EEG). Se compararon las caracteristicas sociodemograficas, clinicas y semiologicas entre los que presentaban y los que no presentaban epilepsia concomitante. Resultados. Se incluyo a 65 pacientes, 35 con CPNE (53,9%), y 30 con CPNE y epilepsia (46,1%). La edad mediana en el inicio del video-EEG fue de 33 años, y un 70,8% eran mujeres. La edad mediana de inicio de las crisis fue de 16 años. En el grupo de CPNE hubo un inicio mas tardio (23 años) en comparacion con el grupo de CNPE y epilepsia (11 años), pero la diferencia no fue significativa. La proporcion de pacientes en terapia con farmacos antiepilepticos fue significativamente mayor en el grupo con CPNE y epilepsia comparado con el grupo con CPNE. Las caracteristicas semiologicas mas frecuentemente encontradas fueron el inicio gradual de las crisis (69,2%) y una duracion de mas de dos minutos (63,1%). Conclusion. La variabilidad en los sintomas sugiere un origen no epileptico de los eventos paroxisticos, los cuales se presentan frecuentemente en pacientes con epilepsia.


Assuntos
Transtorno Conversivo/diagnóstico , Epilepsia/diagnóstico , Convulsões/diagnóstico , Adolescente , Adulto , Ansiedade/complicações , Colômbia , Transtorno Conversivo/complicações , Estudos Transversais , Depressão/complicações , Diagnóstico Diferencial , Eletroencefalografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Convulsões/etiologia , Fatores Socioeconômicos , Avaliação de Sintomas , Fatores de Tempo , Gravação em Vídeo , Adulto Jovem
9.
J Environ Radioact ; 205-206: 79-92, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31121424

RESUMO

Between the end of September and early October 2017, 106Ru was recorded by air monitoring stations across parts of Europe. In the environment, this purely anthropogenic radionuclide can be detected very rarely only. As far as known, 106Ru is only used in radiotherapy and possibly in radiothermal generators. Therefore, the episode drew considerable interest in the monitoring community, although the activity concentrations and resulting exposure were far below radiological concern. Health consequences can be practically excluded except possibly near the source. 106Ru in aerosols could be detected for several weeks and in some regions of Central and Eastern Europe tens, up to over 100 mBq/m³ were measured as one-day means. Discussions about a possible source continue until today (early 2019). Atmospheric back-modelling led to trajectories likely originating in the Southern to Northern Ural region of Russia and possibly Northern Kazakhstan. Suspiciously, no other anthropogenic radionuclides have been observed alongside, except minute concentrations of comparatively short-lived 103Ru (half life 39 d vs. 376 d for 106Ru). Due to the absence of other anthropogenic radionuclides, a reactor accident can be excluded, although both Ru isotopes are fission products generated in nuclear reactors. The exposure resulting from 106Ru activity concentration in air exceeded 200 mBq × d/m³ in some parts of Central and Eastern Europe. This leads to inhalation doses of up to about 0.3 µSv regionally, assuming the radiologically most efficient speciation, lacking better information, and inhalation dose conversion factors from ICRP 119. We show an interpolated map of the dose distribution over parts of Europe where sufficient measurements are available to us. Overlaying population density, we give an estimate of collective dose. The opportunity is also used to give a short review of origin, properties and use of 106Ru, as well as of accidents which involved release of this radionuclide.


Assuntos
Poluentes Radioativos do Ar/análise , Doses de Radiação , Monitoramento de Radiação , Aerossóis/análise , Europa (Continente) , Radioisótopos de Rutênio
10.
Rev. med. vet. zoot ; 66(1): 35-42, ene.-abr. 2019. tab
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1014235

RESUMO

RESUMEN El objetivo de este estudio fue comparar el tiempo de cicatrización entre N-butil cianocrilato (NBC) y ácido poliglicólico (AC) sobre el cierre tisular en caninos sometidos a operaciones de esterilización. Se realizó un estudio observacional, comparativo y descriptivo sobre una población de 80 perros (Canis familiaris) vivos. Los animales se dividieron en cuatro grupos de 20 perros cada uno según sexo y material de sutura, así: primero grupo, hembras que recibieron NBC; segundo grupo, machos y NBC; tercero grupo, hembras y AC como medio de sutura en piel y cuarto grupo, machos y AC. La técnica quirúrgica en hembras fue oforosalpingohisterectomia y en machos orquiectomia. El tiempo de cierre fue estadísticamente (p < 0,05) menor en los grupos de machos y hembras con el adhesivo NBC comparado con los dos grupos tratados con AC. Se concluye que el NBC es un material seguro y eficaz como medio de fijación tisular en ambas técnicas quirúrgicas que disminuye los días de cierre y recuperación.


ABSTRACT The aim of this study was to compare N-butyl cyanoacrylate (NBC) and polyglycolic acid (AC) in tissue closure in canines subjected to sterilization operations. An observational, comparative and descriptive study was conducted in a population of 80 living dogs (Canis familiaris). The animals were divided into 4 groups of 20 dogs each, according to gender and suture material: the first group consisted of females that received NBC; the second group consisted of males that received NBC; the third group consisted of females that received AC as skin suture; and the fourth group was formed by males that received AC. The surgical technique in females was salpingo-oophorectomy, and in males it was orchiectomy. The closure time was statistically (p < 0.05) lower in the male and female groups with the NBC adhesive in comparison to the two groups treated with AC. It was concluded that NBC is a safe and effective material for tissue fixation in both surgical techniques, decreasing times of closure and recovery.

11.
J Environ Radioact ; 198: 1-10, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30557786

RESUMO

7Be, 210Pb and PM10 levels in surface air have been simultaneously measured at two sampling sites in the southern Iberian Peninsula for a period of two years. Each site covers one different meteorological area of the Guadalquivir valley, from the mouth (Huelva) to the middle point (Cordoba). The objective of the present study is to analyse the spatial variability of both natural radionuclides, and to identify and characterise the meteorological patterns associated with similar and different surface concentration levels in this complex region. Concentrations are similar in both sampling sites. 7Be level is in the 0.6-15.5 mBq m-3 range in Huelva and 1.2-13.3 mBq m-3 in Córdoba, 210Pb activity concentrations are between 0.04 and 2.30 mBq m-3 in Huelva, and between 0.03 and 1.2 mBq m-3 in Cordoba, and PM10 concentrations are found to be in the 5.1-81.3 µg m-3 range in Huelva, and 8.2-76.3 µg m-3 in Cordoba, respectively. A linear regression analysis indicates more regional variability for 210Pb than for 7Be between simultaneous measurements. Principal components analysis (PCA) is applied to the datasets and the results reveal that aerosol behaviour is mainly represented by two components, which explain 82% of the total variance. The analysis of surface measurements and meteorological parameters revealed that component F1 groups sampling periods in which the influence of similar meteorological conditions over the region lead to similar 7Be, 210Pb and PM10 concentration levels in both sampling sites. On the other hand, component F2 detaches the 7Be, 210Pb and PM10 concentration levels between monitoring sites, and the meteorological analysis shows how surface concentrations within this component are associated with the development of different mesoscale circulations in each part of the valley. The identification of sampling periods characterised by differences in surface concentrations and wind patterns between stations suggests that the valley could not be considered as one single unit for certain meteorological scenarios. These results evidence how the understanding of wind characteristics within a complex terrain provide some essential knowledge in the regionalization and/or optimization of monitoring networks.


Assuntos
Berílio/análise , Radioisótopos de Chumbo/análise , Conceitos Meteorológicos , Monitoramento de Radiação , Radioisótopos/análise , Poluentes Radioativos do Solo/análise , Poluentes Atmosféricos/análise , Análise de Componente Principal , Espanha
13.
Rev. chil. infectol ; 35(2): 123-132, abr. 2018. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-959421

RESUMO

Resumen Las infecciones asociadas a diálisis peritoneal (DP), corresponden a la principal complicación de los pacientes pediátricos en esta terapia de reemplazo renal, disminuyendo la sobrevida de la membrana peritoneal y empeorando el pronóstico del paciente. El reconocimiento precoz y un tratamiento oportuno de éstas son fundamentales para preservar esta modalidad dialítica. Se presenta una revisión actualizada de la literatura científica, con el fin de entregar recomendaciones reproducibles en los distintos centros pediátricos que realizan diálisis peritoneal crónica en niños.


Peritoneal dialysis-related infections are the main complication in pediatric patients undergoing this renal replacement therapy, associating a high rate of morbidity, generating also a decreasing survival of the peritoneal membrane and worsening the patient outcome. We describe the recommended diagnostic and therapeutic modalities to treat dialysis-related in children.


Assuntos
Humanos , Pré-Escolar , Criança , Infecção da Ferida Cirúrgica/diagnóstico , Infecção da Ferida Cirúrgica/tratamento farmacológico , Diálise Peritoneal/efeitos adversos , Infecções Relacionadas a Cateter/diagnóstico , Infecções Relacionadas a Cateter/tratamento farmacológico , Anti-Infecciosos/uso terapêutico , Infecção da Ferida Cirúrgica/classificação , Infecção da Ferida Cirúrgica/etiologia , Índice de Gravidade de Doença , Fatores de Risco , Infecções Relacionadas a Cateter/etiologia , Anti-Infecciosos/classificação
14.
Transplant Proc ; 50(2): 658-660, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29579881

RESUMO

INTRODUCTION: Lung transplantation is the final treatment option in patients with respiratory failure. Morbidity and mortality rates associated with the management of complications is high despite advances. Postoperative complications include acute transplant rejection, bronchiolitis obliterans, and infections. Because of that, the success of this treatment option depends on the correct choice of donor and candidates to receive a transplant. OBJECTIVE: This study aims to perform a survival analysis of transplanted patients in our center and determine predictive variables of mortality. PATIENTS AND METHODS: This study is a retrospective assessment of data collected from 510 patients at the Hospital University Reina Sofía from October 1993 to December 31, 2016. Patients who were retransplanted were excluded. We collected data regarding basal characteristics of the donors and candidates to receive a transplant. We analyzed the impact in terms of future survival of basal variables from donor and donor recipients. RESULTS: Five hundred ten patients were included (average age 44 ± 17 years, 69% male), with a maximum follow-up period of 21.6 years (average follow-up 4.52 years, interquartile ratio: 0.13 to 6.97 years). Two hundred twenty-seven patients died (54.3% of the total amount). The influence of donor's basal characteristics on mortality was analyzed; moreover, the relationship between basal variables and survival were analyzed using univariate analysis. Available variables were analyzed through multivariate analysis. CONCLUSION: Lung transplantation is a treatment option with an acceptable risk of morbidity and mortality. Increased awareness of features of evolution could help to reduce postoperative complications.


Assuntos
Transplante de Pulmão/mortalidade , Complicações Pós-Operatórias/epidemiologia , Adolescente , Adulto , Feminino , Rejeição de Enxerto/epidemiologia , Humanos , Estimativa de Kaplan-Meier , Transplante de Pulmão/efeitos adversos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Prognóstico , Estudos Retrospectivos , Análise de Sobrevida
15.
Transplant Proc ; 50(2): 661-663, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29579882

RESUMO

INTRODUCTION: Pulmonary fibrosis (PF) is one of the main indications for lung transplantation among end-stage respiratory diseases. PF represents a surgical challenge due to the pulmonary retraction, reduction of pleural space, and limitation for access of the lung hilum by elevation, specifically on the left lung. Unilateral sternothoracotomy, or hemiclamshell (HCS) approach, is the anterolateral thoracotomy with longitudinal partial sternotomy with possibility of cervical extension. This was initially described as a surgical approach for resection of lung apex tumors and of the cervicothoracic region, excision of mediastinal and thoracic wall tumors, and as an urgent incision for the repair of mediastinal and cervicothoracic vascular lesions. HCS is not usually described for liver transplantation. CASE: A 62-year-old man who was a nonsmoker was diagnosed with idiopathic PF. After 3 years of medical management and follow-up, the patient was referred to us for a pretransplantation study. He presented with dyspnea grade III according to the Medical Research Council. In the radiograph of the chest and computed tomography of the thorax showed signs of pulmonary fibrosis predominantly left-lung associated with loss of volume and alteration of respiratory function tests. We performed left single lung transplantation through a left HCS approach. During implantation we converted the superior pulmonary vein into "neo-atrium" for the atrial anastomosis. The patient presented excellent evolution and was discharged from the hospital at 26 days. CONCLUSION: We present a case of left single lung transplantation by PF through an HCS approach as novel and effective resource for this type of procedure.


Assuntos
Fibrose Pulmonar Idiopática/cirurgia , Transplante de Pulmão/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Esternotomia/métodos , Toracotomia/métodos , Resultado do Tratamento
16.
Psychooncology ; 27(6): 1530-1537, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29498768

RESUMO

OBJECTIVE: Patients' psychological reactions to multigene cancer panel testing might differ compared with the single-gene testing reactions because of the complexity and uncertainty associated with the different possible results. Understanding patients' preferences and psychological impact of multigene panel testing is important to adapt the genetic counselling model. METHODS: One hundred eighty-seven unrelated patients with clinical suspicion of hereditary cancer undergoing a 25-gene panel test completed questionnaires after pretest genetic counselling and at 1 week, 3 months, and 12 months after results to elicit their preferences regarding results disclosure and to measure their cancer worry and testing-specific distress and uncertainty. RESULTS: A pathogenic variant was identified in 38 patients (34 high penetrance and 4 moderate penetrance variants), and 54 patients had at least one variant of uncertain significance. Overall, cancer panel testing was not associated with an increase in cancer worry after results disclosure (P value = .87). Twelve months after results, carriers of a moderate penetrance variant had higher distress and uncertainty scores compared with carriers of high penetrance variants. Cancer worry prior to genetic testing predicted genetic testing specific distress after results, especially at long term (P value <.001). Most of the patients reported the wish to know all genetic results. CONCLUSIONS: Our results suggest that patients can psychologically cope with cancer panel testing, but distress and uncertainty observed in carriers of moderate penetrance cancer variants in this cohort warrant further research.


Assuntos
Aconselhamento Genético/psicologia , Predisposição Genética para Doença/psicologia , Testes Genéticos/métodos , Neoplasias/psicologia , Adulto , Ansiedade/psicologia , Estudos de Coortes , Feminino , Predisposição Genética para Doença/prevenção & controle , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/genética , Neoplasias/prevenção & controle , Espanha
17.
Chemosphere ; 199: 278-285, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29448195

RESUMO

Relationships between the beryllium-7 activity concentrations in surface air and meteorological parameters (temperature, atmospheric pressure, and precipitation), teleconnection indices (Arctic Oscillation, North Atlantic Oscillation, and Scandinavian pattern) and number of sunspots are investigated using two multivariate statistical techniques: hierarchical cluster and factor analysis. The beryllium-7 surface measurements over 1995-2011, at four sampling sites located in the Scandinavian Peninsula, are obtained from the Radioactivity Environmental Monitoring Database. In all sites, the statistical analyses show that the beryllium-7 concentrations are strongly linked to temperature. Although the beryllium-7 surface concentration exhibits the well-characterised spring/summer maximum, our study shows that extremely high beryllium-7 concentrations, defined as the values exceeding the 90th percentile in the data records for each site, also occur over the October-March period. Two types of autumn/winter extremes are distinguished: type-1 when the number of extremes in a given month is less than three, and type-2 when at least three extremes occur in a month. Factor analysis performed for these autumn/winter events shows a weaker effect of temperature and a stronger impact of the transport and production signal on the beryllium-7 concentrations. Further, the majority of the type-2 extremes are associated with a very high monthly Scandinavian teleconnection index. The type-2 extremes that occurred in January, February and March are also linked to sudden stratospheric warmings of the Arctic vortex. Our results indicate that the Scandinavian teleconnection index might be a good indicator of the meteorological conditions facilitating extremely high beryllium-7 surface concentrations over Scandinavia during autumn and winter.


Assuntos
Poluentes Radioativos do Ar/análise , Berílio/análise , Monitoramento de Radiação/métodos , Radioisótopos/análise , Atmosfera/química , Pressão Atmosférica , Mudança Climática , Análise Fatorial , Países Escandinavos e Nórdicos , Estações do Ano , Temperatura
19.
Sci Total Environ ; 609: 1340-1348, 2017 Dec 31.
Artigo em Inglês | MEDLINE | ID: mdl-28793403

RESUMO

Given its proximity to northern Africa, southern Spain is regularly affected by high-altitude African intrusions. This determines a well-defined wind dynamics at surface levels. Although this weather event-mainly recorded in spring and summer-coincides with the flowering season of many wind pollinated species, its potential influence on long term airborne pollen transport has been not investigated in detail. We analyse their influence on olive pollen transport at surface level in south Spain. Daily and bi-hourly olive pollen data from 2010 to 2015, recorded at two sites 150km apart, Málaga (coast) and Córdoba (inland), were analysed together with 1) air masses at 300m above ground level (m.a.g.l.), 2) surface wind direction and 3) surface wind speed over the same period. Air masses at 3000m.a.g.l. were used to identify the periods under the influence of African intrusions. The combined analysis has enabled the identification of different pollen patterns and source contributions. In Málaga, hourly pollen peaks were recorded during the early morning coinciding with the arrival of north-westerly winds (developing sea-land breezes), with a minimal impact of local pollen sources; in Córdoba, by contrast, pollen concentrations reflected the joint contribution of local and long term sources, being the maximum concentrations associated with the arrival of southerly air masses in the afternoon. These results help to understand the potential distant sources and back-trajectories of olive pollen detected. In our case pollen from sources located at the west-northwest areas in the case of Malaga, and from the south in Cordoba. These results reinforce the idea that combined studies between synoptic meteorological and aerobiological data together with different atmospheric height air masses data, offer us a better explanation and understanding of the behaviour and the potential sources of recorded airborne data in a given place.

20.
Breast Cancer Res Treat ; 161(3): 597-604, 2017 02.
Artigo em Inglês | MEDLINE | ID: mdl-27913932

RESUMO

PURPOSE: There is still a considerable percentage of hereditary breast and ovarian cancer (HBOC) cases not explained by BRCA1 and BRCA2 genes. In this report, next-generation sequencing (NGS) techniques were applied to identify novel variants and/or genes involved in HBOC susceptibility. METHODS: Using whole exome sequencing, we identified a novel germline mutation in the moderate-risk gene ATM (c.5441delT; p.Leu1814Trpfs*14) in a family negative for mutations in BRCA1/2 (BRCAX). A case-control association study was performed to establish its prevalence in Spanish population, in a series of 1477 BRCAX families and 589 controls further screened, and NGS panels were used for ATM mutational screening in a cohort of 392 HBOC Spanish BRCAX families and 350 patients affected with diseases not related to breast cancer. RESULTS: Although the interrogated mutation was not prevalent in case-control association study, a comprehensive mutational analysis of the ATM gene revealed 1.78% prevalence of mutations in the ATM gene in HBOC and 1.94% in breast cancer-only BRCAX families in Spanish population, where data about ATM mutations were very limited. CONCLUSION: ATM mutation prevalence in Spanish population highlights the importance of considering ATM pathogenic variants linked to breast cancer susceptibility.


Assuntos
Proteínas Mutadas de Ataxia Telangiectasia/genética , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/genética , Estudos de Associação Genética , Predisposição Genética para Doença , Mutação em Linhagem Germinativa , Adulto , Proteínas Mutadas de Ataxia Telangiectasia/metabolismo , Estudos de Casos e Controles , Análise Mutacional de DNA , Feminino , Genes BRCA1 , Genes BRCA2 , Humanos , Imuno-Histoquímica , Perda de Heterozigosidade , Linhagem , Prevalência , Espanha/epidemiologia , Sequenciamento do Exoma
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