Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 2.621
Filtrar
1.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-38508379

RESUMO

BACKGROUND AND OBJECTIVES: The diagnostic suspicion of an atypical lipomatous tumour (ALT) is difficult. The aim of this study is to delve into the most controversial diagnostic aspects of the subject. MATERIAL AND METHOD: Observational, longitudinal and retrospective study of a series of 96 deep adipose tumours (75 lipomas and 21 TLA) from 2006 to 2016: demographic, clinical, imaging and pathological variables were analysed and compared, as well as other variables related to treatment and oncological outcomes of the patients. A descriptive analysis of the collected variables was performed for the statistical study. To evaluate the potential predictor variables of malignancy, a multivariate logistic regression analysis was performed, including those that were statistically significant in the univariate analysis. RESULTS: Older age at diagnosis, lower limb location and larger size were significantly more frequent in ALTs. MRI findings showed no statistically significant differences between the two groups. In multivariate analysis, the same clinical variables were confirmed as predictors of malignancy. In the ROC curve, an optimal cut-off point of 134.0mm was used as a predictor of malignancy. CONCLUSIONS: Advanced age, location in the lower limbs and larger size are risk factors for malignancy in the differential diagnosis of deep lipomas and atypical lipomatous tumours. No radiological variable on MRI reached significance as a predictor of malignancy in our series.

2.
Cir. mayor ambul ; 29(1): 43-46, Ene-Mar, 2024. ilus
Artigo em Espanhol | IBECS | ID: ibc-231075

RESUMO

La pseudoartrosis es una complicación caracterizada por la ausencia de consolidación del hueso a los 9 meses desde el inicio de la fractura, con falta de progresión radiológica los últimos 3 meses, siendo sus principales causas el exceso de movimiento en el foco de fractura y una insuficiente vascularización. A pesar de no tratarse de una complicación frecuente, los huesos del antebrazo ocupan el 4.º puesto en incidencia de presentación. El manejo anestésico de la patología quirúrgica del miembro superior se realiza generalmente en régimen ambulatorio con técnicas de anestesia regional guiadas por ecografía. Estas técnicas tienen una doble función: anestesia durante el propio acto quirúrgico con una mínima variabilidad sobre el estado basal del paciente y analgesia en el postoperatorio inmediato, permitiendo de esta manera el alta a domicilio de forma más segura y precoz. Presentamos el caso de un varón de 34 años, con desarrollo de pseudoartrosis atrófica tras fractura diafisaria de radio, en el que se realiza injerto óseo de cresta ilíaca y aspirado de células madre como estímulo de la osteogénesis.(AU)


Pseudarthrosis is a complication characterised by the absence of bone healing 9 months after the onset of the fracture, with a lack of radiological progressionin the last 3 months, and its main causes are excessive movement at the fracture site and insufficient vascularisation. Despite not being a frequent complica-tion, the bones of the forearm occupy the fourth place in incidence of presentation. The anaesthetic management of surgical pathology of the upper limb isgenerally performed on an outpatient basis with regional anaesthesia techniques guided by ultrasound. These techniques have a dual function: anaesthesiaduring the surgical act with minimal variability over the patient’s baseline condition and analgesia in the immediate postoperative period, thus allowing forsafer and earlier discharge home. We present the case of a 34-year-old male with diagnosis of atrophic pseudarthrosis following a diaphyseal fracture of theradius, in whom iliac crest bone grafting and stem cell aspiration were performed to stimulate osteogenesis.(AU)


Assuntos
Humanos , Masculino , Adulto , Pseudoartrose , Transplante Ósseo , Transplante de Medula Óssea , Rádio (Anatomia)/cirurgia , Anestesia por Condução , Ílio , Pacientes Internados , Exame Físico , Fraturas Ósseas/cirurgia , Anestesia , Células-Tronco
3.
SEMERGEN, Soc. Esp. Med. Rural Gen. (Ed. Impr.) ; 50(1): [e102092], ene.- feb. 2024.
Artigo em Inglês | IBECS | ID: ibc-229435

RESUMO

Objective The aim of our research was to compare the evolution of the immune response induced by the BNT162b2 vaccine after the administration of two and three doses in healthcare personnel and in institutionalized elderly people (>65 years of age) without previous SARS-CoV-2 infection. Material and methods A prospective observational study was carried out on a convenience sample made up of health workers and institutionalized elderly people, measuring antibodies against S and N proteins of SARS-CoV-2 two and six months after receiving the second vaccine dose, as well as two months after receiving the third dose. Results A significant reduction of the anti-S humoral immune response was reported six months after the second dose of vaccine in both health workers and residents. The administration of a third dose of vaccine induced a significant increase in this antibody response in both investigated groups reaching a similar proportion of responders two months after this third dose. Conclusions Humoral immunity induced by two doses of the BNT162b2 vaccine in persons without prior SARS-CoV-2 infection wanes over time. The administration of a third dose significantly increases anti-S antibodies being highly recommended, especially in people over 65 years of age (AU)


Objetivo El objetivo de nuestra investigación fue comparar la evolución de la respuesta inmunitaria humoral inducida por la vacuna BNT162b2 tras la administración de 2 y 3 dosis en personal sanitario y en personas mayores institucionalizadas (>65años) sin infección previa por SARS-CoV-2. Material y métodos Se realizó un estudio observacional prospectivo en una muestra de conveniencia conformada por sanitarios y mayores institucionalizados, determinando anticuerpos contra las proteínas S y N del SARS-CoV-2 a los 2 y 6 meses de recibir la segunda dosis de la vacuna, así como a los 2 meses después de recibir la tercera dosis. Resultados Se observó una reducción significativa de la respuesta inmune humoral anti-S 6 meses después de la segunda dosis de vacuna, tanto en sanitarios como en residentes. La administración de una tercera dosis de vacuna indujo un aumento significativo de esta respuesta de anticuerpos en ambos grupos, alcanzándose una proporción similar de individuos respondedores a los 2 meses de esta tercera dosis. Conclusiones La inmunidad humoral inducida por 2 dosis de la vacuna BNT162b2 en personas sin infección previa por SARS-CoV-2 disminuye con el tiempo. La administración de una tercera dosis aumenta significativamente los anticuerpos anti-S siendo muy recomendable, especialmente en personas mayores de 65 años (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Pessoal de Saúde , Saúde do Idoso Institucionalizado , /prevenção & controle , /administração & dosagem , /imunologia , Imunogenicidade da Vacina , Estudos Prospectivos
4.
Scand J Med Sci Sports ; 34(3): e14588, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38415784

RESUMO

OBJECTIVES: Determine if (a) a better trunk stability and endurance are associated with an improved whole-body dynamic balance, and if (b) the assessment tests can be interchanged within each capability. METHODS: Sixty-three physically active young males performed three trunk stability (i.e., the lumbopelvic stability, the unstable sitting and the sudden loading sitting tests), three trunk muscle endurance (i.e., the Biering-Sørensen, the side bridge and the front bridge tests) and four whole-body dynamic balance (i.e., the tandem and the single-leg stance, the Y-Balance, and the single-leg triple hop tests) tests two times. After assessing the reliability of the variables, a Pearson correlation analysis was performed. RESULTS: The correlations between trunk stability and endurance tests with dynamic balance tests were non-significant except for the unstable sitting test with both the tandem (r = 0.502) and the single-leg stance (r = 0.522) tests. Moreover, no relationships were observed between the trunk stability and the trunk muscle endurance tests. Interestingly, no relationships were found between most tests within each capability (i.e., trunk stability, trunk endurance, and dynamic balance) except: (i) the front bridge stability test and the back (r = 0.461) and the side (r = 0.499) bridge stability tests; (ii) the two side bridge endurance tests (r = 0.786); (iii) the tandem and the single-leg stance tests (0.439 ≤ r ≤ 0.463); (iv) the Y-Balance and the single-leg triple hop tests (0.446 ≤ r ≤ 0.477). CONCLUSION: Better trunk function does not seem to be a relevant factor for dynamic balance in young active males. In this population, specific measures are needed as the test interchangeability is questioned.


Assuntos
Estado Nutricional , Postura Sentada , Masculino , Humanos , Reprodutibilidade dos Testes
5.
Braz J Biol ; 84: e279258, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38422297

RESUMO

Species of the genus Anastrepha cause injuries to several fruits and vegetables in the Nearctic and Neotropical regions. Among these species, many are present in Brazil. In this study, we surveyed the existing Anastrepha species in the Brazilian Chaco Biome. We evaluated possible influences of climate and vegetation on the occurrence of Anastrepha spp. For this, we used traps and hydrolyzed protein as bait. Collections were carried out in three distinct floristic compositions in the Chaco biome, from permanently dry areas to flooded sites. We identified Anastrepha fraterculus (Wiedemann, 1830), A. sororcula Zucchi 1979, A. undosa Stone 1942, and A. daciformis Bezzi 1909. The dry and flooded environment did not influence the occurrence of Anastrepha species. The presence of multiple hosts increases the number of species. The richness and abundance of Anastrepha species are lower in the Brazilian Chaco than in other native environments.


Assuntos
Tephritidae , Animais , Ecossistema , Brasil , Frutas , Inquéritos e Questionários
6.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-38367908

RESUMO

INTRODUCTION AND OBJECTIVE: Among the many treatments for erectile dysfunction, implantation of a penile prosthesis has been associated with high patient satisfaction rates. However, patients with coexistent Peyronie's disease (PD) and refractory erectile dysfunction and/or severe deformities may show different results. The aim of our study was to assess and to compare the level of satisfaction, with an inflatable penile prosthesis (IPP), in men with/without coexistent PD. MATERIAL AND METHODS: A survey study based on a five-item satisfaction questionnaire was submitted to all those live patients implanted in the period 1992-2022 at our center (n = 570) and their partners. Ninety-two percent of implants were inflatable devices. Surgeries were mainly performed by two surgeons. The main outcome measure used was the level of patient and partner satisfaction with sexual intercourse after IPP. RESULTS: Of the 570 eligible patients, 479 (84%) completed the survey (393 Non-PD: GROUP 1; 70 non-complex PD-Group 2; 16 complex PD). Eighty-six per cent of patients in Group 1 reported satisfactory sexual intercourse (very or moderately satisfied). Non-complex PD implanted patients (Group 2) reported a global 81% satisfactory sexual intercourse (very or moderately satisfied) (p > 0.05). However, when we evaluated the PD subgroup of patients with severe PD who require incision/excision/grafting at the time of implant (Group 3: n = 20), only 61% reported satisfactory sexual intercourse (p < 0.01) with predominance of moderately satisfied patients over very satisfied: 78% vs. 22%). Additionally, 84% (Group 1), 80% (Group 2) and 54% (Group 3) of partners reported satisfactory intercourses, respectively (p < 0.01). Overall, 84% of Group 1 implants and 79% of Group 2 reported that they would undergo the procedure again if the IPP failed (p > 0.05; ns). Only 50% of Group 3 patients would do it again. With regard to cosmetic aspects, 48% of the Group 3 implant reported penile shortness or soft glans as the main causes of their dissatisfaction. Only 2.4% of total PP patients expressed difficulty in manipulating the device. CONCLUSION: The presence of PD alone may not impact PP patient and partner satisfaction, but patients with more severe baseline deformity who require incision/grafting may be less satisfied with outcomes including penile length and glans sensation.

7.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-38253238

RESUMO

INTRODUCTION: Bone defects are one of the main limitations in orthopaedic surgery and traumatology. For this reason, multiple bone replacement systems have been developed, either by prosthetic implant or by substitution with osteoforming substances, whose limitations are their survival and lack of structurality, respectively. The objective of this work is the generation of a new material for the creation of biologically active structures that have sufficient tensile strength to maintain the structure during remodelling. MATERIAL AND METHODS: A new filament based on the fusion of natural polylactide acid (PLA) powder was designed for the generation of pieces by means of fused deposition modelling (FDM) on which to carry out tensile mechanical tests of osteosynthesis material. A total of 13 groups with different cortical thickness, filling and layer height were carried out, with 10 tensile tests in each group, defining the tensile breaking limit for each group. The regression lines for each group and their mechanical resistance to traction on the filament used were determined. RESULTS: The filament ratio per contact surface unit with the osteosynthesis used was the main determinant of the mechanical resistance to traction, either at the expense of the increase in cortical thickness or by the increase in the percentage of cancellous bone filling. Layer height had a minor effect on tensile strength. The regression value was high for cortical thickness and cancellous filling, being elements with a predictable biomechanical behaviour. CONCLUSIONS: The new methodology allows the creation of personalised neutral and implantable PLA bone matrices for the reconstruction of large bone defects by means of 3D printing by FDM with a mechanical resistance to traction greater than that of current biological support structures.

8.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-38199434

RESUMO

BACKGROUND AND OBJECTIVES: The diagnostic suspicion of an atypical lipomatous tumour (ALT) is difficult. The aim of this study is to delve into the most controversial diagnostic aspects of the subject. MATERIAL AND METHOD: Observational, longitudinal, and retrospective study of a series of 96 deep adipose tumours (75 lipomas and 21 TLA) from 2006 to 2016: demographic, clinical, imaging and pathological variables were analysed and compared, as well as other variables related to treatment and oncological outcomes of the patients. A descriptive analysis of the collected variables was performed for the statistical study. To evaluate the potential predictor variables of malignancy, a multivariate logistic regression analysis was performed, including those that were statistically significant in the univariate analysis. RESULTS: Older age at diagnosis, lower limb location and larger size were significantly more frequent in ALTs. MRI findings showed no statistically significant differences between the two groups. In multivariate analysis, the same clinical variables were confirmed as predictors of malignancy. In the ROC curve, an optimal cut-off point of 134.0 mm was used as a predictor of malignancy. CONCLUSIONS: Advanced age, location in the lower limbs and larger size are risk factors for malignancy in the differential diagnosis of deep lipomas and atypical lipomatous tumours. No radiological variable on MRI reached significance as a predictor of malignancy in our series.

9.
Mar Environ Res ; 193: 106256, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38006852

RESUMO

Widespread habitat-forming invaders inhabiting marinas, such as the spaghetti bryozoan Amathia verticillata, allow exploring facilitation processes across spatiotemporal contexts. Here we investigate the role of this bryozoan as habitat for native and exotic macrofaunal assemblages across different ecoregions of Western Mediterranean and East Atlantic coasts, and a monthly variation over a year. While only 7 (all peracarid crustaceans) of the 54 associated species were NIS, they dominated macrofaunal assemblages in terms of abundance, raising the potential for invasional meltdown. NIS richness and community structure differed among marinas but not among ecoregions, highlighting the importance of marina singularities in modulating facilitation at spatial scale. Despite facilitation did not depend on bryozoan abundance fluctuations, it was affected by its deciduous pattern, peaking in summer and disappearing in late winter. Monitoring A. verticillata in marinas, especially in summer periods, may improve the detection and management of multiple associated NIS.


Assuntos
Briozoários , Animais , Espécies Introduzidas , Ecossistema , Crustáceos , Alimentos
10.
Semergen ; 50(1): 102092, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-37832164

RESUMO

OBJECTIVE: The aim of our research was to compare the evolution of the immune response induced by the BNT162b2 vaccine after the administration of two and three doses in healthcare personnel and in institutionalized elderly people (>65 years of age) without previous SARS-CoV-2 infection. MATERIAL AND METHODS: A prospective observational study was carried out on a convenience sample made up of health workers and institutionalized elderly people, measuring antibodies against S and N proteins of SARS-CoV-2 two and six months after receiving the second vaccine dose, as well as two months after receiving the third dose. RESULTS: A significant reduction of the anti-S humoral immune response was reported six months after the second dose of vaccine in both health workers and residents. The administration of a third dose of vaccine induced a significant increase in this antibody response in both investigated groups reaching a similar proportion of responders two months after this third dose. CONCLUSIONS: Humoral immunity induced by two doses of the BNT162b2 vaccine in persons without prior SARS-CoV-2 infection wanes over time. The administration of a third dose significantly increases anti-S antibodies being highly recommended, especially in people over 65 years of age.


Assuntos
COVID-19 , Vacinas , Idoso , Humanos , Vacina BNT162 , COVID-19/epidemiologia , COVID-19/prevenção & controle , Pessoal de Saúde , SARS-CoV-2 , Estudos Prospectivos
11.
Brain Res ; 1822: 148636, 2024 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-37865139

RESUMO

Macamides, amides of fatty acids first isolated from maca (Lepidium meyenii) are potentially responsible for the reduction of ischemic injury in the stroke animal model followed by maca extract administration. This deduction comes from its ability to inhibit the fatty acid amide hydrolase activity, an enzyme related to the endocannabinoid anandamide hydrolysis. However, no study about the effects of isolated macamides on in-vivo models has been published yet. Our objective was to evaluate the effect of a 10-day 30 mg/kg i.p. MCH1 administration, the macamide with the higher FAAH inhibition capability, on the neurological recovery and brain infarction area of Sprague-Dawley rats exposed to the transient middle cerebral artery occlusion (MCAO) model. Our results showed that the group receiving MCH1 for 10 days did not improve Garcia's neurological score compared to receiving the vehicle only. Likewise, the MCH1 group did not improve their sensorimotor dysfunction as indicated by the latency to detect and remove the tape from the contralateral forepaw in the adhesive removal test, and a similar number of errors with the contralateral forepaw in the foot fault test compared to the vehicle group at the 10th day. Evaluation of the spatial memory and learning using the Barnes test showed longer latency to reach the escape box in the Vehicle and MCH1 groups compared to the control group (no MCAO) only in the retrieval test, while no effect of MCAO procedure or MCH1 administration was observed in the reversal learning test. Despite the lack of behavioral effect of MCH1, analysis of the infarcted areas in the brain using the 2, 3, 5-Triphenyltetrazolium chloride (TTC) staining method in the seven consecutive coronal sections revealed that the infarcted area in the first (bregma + 4.2 mm) and fifth (bregma -3.8 mm) coronal sections of the MCAO + MCH1 group remained similar to the Control group. These results provide evidence that MCH1 can limit damage from ischemic stroke, although it is not reflected in neurological or sensorimotor behavior and spatial learning and memory.


Assuntos
Infarto da Artéria Cerebral Média , Córtex Motor , Acidente Vascular Cerebral , Animais , Ratos , Modelos Animais de Doenças , Infarto da Artéria Cerebral Média/tratamento farmacológico , Córtex Motor/efeitos dos fármacos , Ratos Sprague-Dawley , Aprendizagem Espacial/efeitos dos fármacos , Amidoidrolases/antagonistas & inibidores
12.
Theriogenology ; 216: 53-61, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38157807

RESUMO

We aimed to evaluate the efficiency of hard-gelatin and hard-hydroxypropyl methylcellulose (HPMC) capsules as biodegradable alternative containers to plastic straws in European eel (Anguilla anguilla), gilthead seabream (Sparus aurata) and European sea bass (Dicentrarchus labrax) sperm cryopreservation. Sperm samples from each European eel (n = 12) were diluted 1:8:1 (sperm: extender P1+5 % egg yolk: methanol). Gilthead seabream (n = 12) samples were individually diluted in a cryoprotectant solution of 5 % Me2SO + NaCl 1 % plus BSA (10 mg mL-1) at a ratio of 1:6 (sperm: cryoprotectant solution). European sea bass (n = 10) sperm from each male was diluted in non-activating medium (NAM) at a ratio of 1:5.7 (sperm: NAM), and 5 % of Me2SO was added. The diluted European eel and sea bass sperm aliquots (0.5 mL) were individually filled in plastic straws (0.5 mL), hard-gelatin, and HPMC capsules (0.68 mL). Gilthead seabream diluted sperm (0.25 mL) were filled in plastic straws (0.25 mL) and identical capsules described. All samples were frozen in liquid nitrogen vapor and stored in a liquid nitrogen tank. Sperm kinetic parameters were evaluated by CASA-Mot software. Sperm membrane integrity was performed using a Live and Dead KIT and an epifluorescence microscope. To quantify DNA damage, the alkaline comet assay was performed and TailDNA (TD-%) and Olive Tail Moment (OTM) were evaluated by CaspLab software. Sperm cryopreservation of the three Mediterranean species in straws, gelatin, or HPMC capsules reduced the kinetic parameters and cell membrane integrity. Generally, the post-thawing samples cryopreserved in straws and capsules did not differ for the kinetic parameters and cell membrane integrity, except for European sea bass sperm, where the samples stored in gelatin capsules showed higher velocities (VCL - 100; VSL - 76; VAP - 90 µm s-1) than the sperm stored in HPMC capsules (VCL - 87; VSL - 59; VAP - 73 µm s-1). The cryopreservation process did not damage the sperm DNA of European eel and European sea bass, regardless of the containers used. On the other hand, gilthead seabream sperm cryopreserved in gelatin (TD - 9.8 %; OTM - 9.7) and HPMC (TD - 11.1 %; OTM - 11.2) capsules showed higher DNA damage than fresh samples (TD - 3.6 %; OTM - 2.7) and the sperm stored in straws (TD - 4.4 %; OTM - 5.2). The hard-gelatin and HPMC biodegradable capsules can be used as an alternative to straws for European eel, gilthead seabream, and European sea bass sperm cryopreservation.


Assuntos
Bass , Dourada , Preservação do Sêmen , Masculino , Animais , Gelatina/farmacologia , Gelatina/metabolismo , Motilidade dos Espermatozoides , Sêmen , Criopreservação/veterinária , Espermatozoides/metabolismo , Crioprotetores/farmacologia , Crioprotetores/metabolismo , Aquicultura , Nitrogênio , Preservação do Sêmen/veterinária
13.
Rev. esp. cir. ortop. traumatol. (Ed. impr.) ; 67(6): 505-510, Nov-Dic. 2023. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-227619

RESUMO

Las metástasis a nivel occipito-cervical corresponden solo al 0,5% de las metástasis del raquis. El manejo de estas lesiones es complejo y conlleva múltiples estudios radiológicos, tales como la radiología simple, la tomografía computarizada (TAC) o la resonancia magnética (RM). Ante la sospecha de afectación vascular también será recomendable la realización de pruebas que valoren la permeabilidad vascular (angio-TC, angio-RM). Este tipo de lesiones, debido a su compleja localización, puede precisar distintos tipos de vías de abordaje; comúnmente será el abordaje posterior, pero en ocasiones se necesitarán abordajes anteriores o anterolaterales asistidos por cirujanos maxilofaciales u otorrinolaringólogos para una correcta exéresis de la tumoración. El dolor con los giros puede orientarnos al diagnóstico en una columna inestable. La RM es la prueba de elección para diagnosticar y estudiar estas lesiones. La presencia de inestabilidad o de clínica neurológica progresiva es indicación de cirugía.(AU)


Occipito-cervical metastases correspond to 0.5% of spinal metastases. The management of these lesions is complex and involves multiple radiological studies, such as simple radiology, computed tomography (CT), magnetic resonance imaging (MRI). Is vascular involvement is suspected, tests to assess vascular permeability are also recommended (angioCT). This type of lesion, due to its complex location, may require different types of approaches, commonly it will be the posterior approach, but sometimes anterior or anterolateral approaches will be needed assisted by maxillofacial surgeons or otorhinolaryngologists for correct excision of the tumor. Pain with head turning can guide us to the diagnosis in an unstable spine. Magnetic resonance is the test of choice to diagnose and study these lesions. The presence of instability or progressive neurological symptoms are an indication for surgery.(AU)


Assuntos
Humanos , Masculino , Feminino , Metástase Neoplásica , Coluna Vertebral , Neoplasias da Coluna Vertebral , Neoplasias Ósseas/tratamento farmacológico , Espectroscopia de Ressonância Magnética/uso terapêutico , Prognóstico , Traumatologia , Procedimentos Ortopédicos , Ortopedia , Neoplasias/tratamento farmacológico , Técnicas e Procedimentos Diagnósticos , Diagnóstico por Imagem/métodos
14.
Rev. esp. cir. ortop. traumatol. (Ed. impr.) ; 67(6): S505-S510, Nov-Dic. 2023. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-227621

RESUMO

Las metástasis a nivel occipito-cervical corresponden solo al 0,5% de las metástasis del raquis. El manejo de estas lesiones es complejo y conlleva múltiples estudios radiológicos, tales como la radiología simple, la tomografía computarizada (TAC) o la resonancia magnética (RM). Ante la sospecha de afectación vascular también será recomendable la realización de pruebas que valoren la permeabilidad vascular (angio-TC, angio-RM). Este tipo de lesiones, debido a su compleja localización, puede precisar distintos tipos de vías de abordaje; comúnmente será el abordaje posterior, pero en ocasiones se necesitarán abordajes anteriores o anterolaterales asistidos por cirujanos maxilofaciales u otorrinolaringólogos para una correcta exéresis de la tumoración. El dolor con los giros puede orientarnos al diagnóstico en una columna inestable. La RM es la prueba de elección para diagnosticar y estudiar estas lesiones. La presencia de inestabilidad o de clínica neurológica progresiva es indicación de cirugía.(AU)


Occipito-cervical metastases correspond to 0.5% of spinal metastases. The management of these lesions is complex and involves multiple radiological studies, such as simple radiology, computed tomography (CT), magnetic resonance imaging (MRI). Is vascular involvement is suspected, tests to assess vascular permeability are also recommended (angioCT). This type of lesion, due to its complex location, may require different types of approaches, commonly it will be the posterior approach, but sometimes anterior or anterolateral approaches will be needed assisted by maxillofacial surgeons or otorhinolaryngologists for correct excision of the tumor. Pain with head turning can guide us to the diagnosis in an unstable spine. Magnetic resonance is the test of choice to diagnose and study these lesions. The presence of instability or progressive neurological symptoms are an indication for surgery.(AU)


Assuntos
Humanos , Masculino , Feminino , Metástase Neoplásica , Coluna Vertebral , Neoplasias da Coluna Vertebral , Neoplasias Ósseas/tratamento farmacológico , Espectroscopia de Ressonância Magnética/uso terapêutico , Prognóstico , Traumatologia , Procedimentos Ortopédicos , Ortopedia , Neoplasias/tratamento farmacológico , Técnicas e Procedimentos Diagnósticos , Diagnóstico por Imagem/métodos
16.
BMC Med Res Methodol ; 23(1): 294, 2023 12 14.
Artigo em Inglês | MEDLINE | ID: mdl-38097923

RESUMO

OBJECTIVES: This research-on-research substudy uses a data-driven approach to investigate the range of appraisal tools in non-Cochrane systematic reviews and meta-analyses registered in the International Prospective Register of Systematic Reviews (PROSPERO). STUDY DESIGN AND SETTING: A comprehensive web scraping of all completed non-Cochrane registrations in PROSPERO from February 2011 to December 2017 was performed. The focus was classifying the appraisal tools based on study type, assessment aspects, and research topics. RESULTS: After analyzing 17,708 complete records, we found a predominant use of methodological quality assessment tools compared to those for reporting quality or risk of bias (RoB). This indicates a greater emphasis on methodological rigor in the studied protocols. Various tools for assessing methodological quality were observed, reflecting the complexity of such evaluations. Instruments designed for evaluating methodological or reporting quality were mainly intended for non-randomized clinical trials or observational studies, unlike RoB tools more commonly used in randomized clinical trials. No distinct trends in tool usage were observed in specific research conditions or domains, suggesting that tool choice is influenced more by study design than research topic. CONCLUSION: This study provides insights into the preferential use of various assessment tools in conducting non-Cochrane systematic reviews, as evidenced in PROSPERO records. The findings reveal various methodological assessment tools, underscoring their versatility across different study designs and research areas.


Assuntos
Metanálise como Assunto , Projetos de Pesquisa , Revisões Sistemáticas como Assunto , Humanos , Viés
18.
Metabolites ; 13(11)2023 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-37999239

RESUMO

Chikungunya virus (CHIKV) is transmitted to humans by mosquitoes of the genus Aedes, causing the chikungunya fever disease, associated with inflammation and severe articular incapacitating pain. There has been a worldwide reemergence of chikungunya and the number of cases increased to 271,006 in 2022 in the Americas alone. The replication of CHIKV takes place in several cell types, including phagocytic cells. Monocytes and macrophages are susceptible to infection by CHIKV; at the same time, they provide protection as components of the innate immune system. However, in host-pathogen interactions, CHIKV might have the ability to alter the function of immune cells, partly by rewiring the tricarboxylic acid cycle. Some viral evasion mechanisms depend on the metabolic reprogramming of immune cells, and the cell metabolism is intertwined with circadian rhythmicity; thus, a circadian immunovirometabolism axis may influence viral pathogenicity. Therefore, analyzing the interplay between viral infection, circadian rhythmicity, and cellular metabolic reprogramming in human macrophages could shed some light on the new field of immunovirometabolism and eventually contribute to the development of novel drugs and therapeutic approaches based on circadian rhythmicity and metabolic reprogramming.

19.
J Nutr Health Aging ; 27(10): 808-816, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37960903

RESUMO

OBJECTIVES: To evaluate the measurement structure of the ICOPE screening tool (IST) of intrinsic capacity and to find out whether the IST as a global measure adds explanatory power over and above its domains in isolation to predict the occurrence of adverse health outcomes such as dependence and hospitalization in community-dwelling older people. DESIGN: Secondary analysis of a cohort study, the Toledo Study of Healthy Ageing. SETTING: Province of Toledo, Spain. PARTICIPANTS: Community-dwelling older people. MEASUREMENTS: Items equal or similar to those of the IST were introduced as a reflective-formative construct in a Structural Equation Model to evaluate its measurement structure and its association with dependence for basic and instrumental activities and hospitalization over a three-year period. RESULTS: A total of 1032 individuals were analyzed. Mean age was 73.5 years (sd 5.4). The least preserved indicators were ability to recall three words (18%) and to perform chair stands (54%). Vision and hearing items did not form a single sensory domain, so six domains were considered. Several cognition items did not show sufficiently strong and univocal associations with the domain. After pruning the ill-behaved items, the measurement model fit was excellent (Satorra-Bentler scaled chi-square: 10.3, degrees of freedom: 11, p=0.501; CFI: 1.000; RMSEA: 0.000, 90% CI: 0.000-0.031, p value RMSEA<=0.05: 1; SRMR: 0.055). In the structural model, the cognition domain items were not associated as expected with age (p values 0.158 and 0.293), education (p values 0.190 and 0.432) and dependence (p values 0.654 and 0.813). The IST included as a composite in a model with the individual domains showed no statistically significant associations with any of the outcomes (dependence for basic activities: 0.162, p=0.167; instrumental: -0.052, p=0.546; hospitalization: 0.145, p=0.167), while only the mobility domain did so for dependence (basic: -0.266, p=0.005; instrumental: -0.138, p=0.019). The model fit of the last version was good (Satorra-Bentler scaled chi-square: 52.1, degrees of freedom: 52, p=0.469; CFI: 1.000; TLI: 1.000; RMSEA: 0.01, 90% CI: 0.000-0.02, p value RMSEA<=0.05: 1; SRMR: 0.071). The IST operationalized as the sum of non-impaired domains was not associated after covariate adjustment (dependence for basic activities: -0.065, p=0.356; instrumental: -0.08, p=0.05; hospitalization: -0.003, p=0.949) either. CONCLUSION: The cognitive domain of the IST, and probably other of its items, may need a reformulation. A global measure of intrinsic capacity such as the IST does not add explanatory power to the individual domains that constitute it. So far, our results confirm the importance of checking the findings of the IST with a second confirmatory step, as described in the WHO's ICOPE strategy.


Assuntos
Cognição , Vida Independente , Humanos , Idoso , Estudos de Coortes , Inquéritos e Questionários , Hospitalização , Reprodutibilidade dos Testes , Psicometria
20.
Oper Dent ; 48(6): 627-637, 2023 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-37881142

RESUMO

OBJECTIVES: The present study aimed to evaluate the desensitizing effect of toothpaste for sensitive teeth on patient tooth sensitivity and on bleaching efficacy of the 38% hydrogen peroxide bleaching agent used for in-office bleaching compared to a regular toothpaste in a randomized clinical trial. METHODS AND MATERIALS: Forty-eight patients having maxillary right central incisors with darkness greater than A1 were selected for the present double-blind randomized clinical trial. Patients were randomly allocated into two groups: the placebo group, which used regular toothpaste, and the experimental group, which used sensitivity toothpaste. The intervention consisted of applying toothpaste with the aid of an individual tray for a period of 4 minutes daily, starting one week before the first bleaching session and interrupting use immediately after the second session. After allocation to one of the groups, individuals received in-office dental bleaching with a 40-minute application of 38% hydrogen peroxide for two sessions with an interval of one week. The incidence and intensity of sensitivity were assessed using a visual analogue scale and a numeric analogue scale. Sensitivity was measured immediately before each session, 1 hour, 24 hours, and 48 hours after each bleaching session and four weeks after the second bleaching session. Tooth shade was evaluated using a spectrophotometer and by comparison with the VITA Classical Shade Guide (Vita Zahnfabrik, Bad Säckingen, Germany). Tooth shade was evaluated before the first bleaching session, one week after the first bleaching session, one week after the second bleaching session and four weeks after the second bleaching session. Participants and professionals who performed the bleaching, shade, and sensitivity assessments were blinded to the group of patients they were treating or assessing. For the incidence of hypersensitivity, the results were evaluated by comparing the groups at different evaluation times with the Mann-Whitney test for comparison between groups, the Friedman test for repeated measures, and the Tukey test for comparison of times. Shade change on the guide was analyzed using the Mann-Whitney test for comparison between groups and the Wilcoxon test for comparison between times. Shade change by the spectrophotometer was analyzed using the t-test for comparison between groups and the paired t-test for comparison between times. All analyses were performed with a significance level of 5%. RESULTS: There was no difference in the pattern of dental hypersensitivity between groups. For all shade measures, there was no difference between the bleaching results, and no statistically significant difference was observed between the study groups. CONCLUSION: The use of arginine-based desensitizing toothpaste did not interfere with the bleaching ability of hydrogen peroxide and was not effective in reducing the sensitivity caused by in-office tooth bleaching.


Assuntos
Sensibilidade da Dentina , Clareadores Dentários , Clareamento Dental , Humanos , Sensibilidade da Dentina/etiologia , Peróxido de Hidrogênio/uso terapêutico , Cremes Dentais/uso terapêutico , Clareadores Dentários/uso terapêutico , Clareamento Dental/efeitos adversos , Clareamento Dental/métodos , Resultado do Tratamento
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...