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1.
J Cutan Pathol ; 2024 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-38468572

RESUMO

Anetoderma or macular atrophy is a rare skin condition of unclear pathogenesis, often associated with autoimmune diseases and skin damage from various infections. Human immunodeficiency virus (HIV), syphilis, and poxviruses have been implicated in the development of anetoderma. A 37-year-old male patient with HIV and recent unprotected sexual encounters presented with more than 400 skin lesions, consistent with Mpox. Symptomatic treatment for Mpox resulted in acute symptom resolution. However, 8 months later he developed papular anetoderma lesions in areas previously affected by Mpox. Biopsy confirmed the loss of elastic fibers in the affected skin areas, leading to the diagnosis of Mpox-induced anetoderma. This report presents a unique case of anetoderma following Mpox in an HIV-positive patient.

2.
Open Respir Arch ; 6(1): 100290, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38293643

RESUMO

Introduction: COVID-19 pneumonia results in an impairment of the diaphragmatic musculature that influences the development of respiratory failure during the patient's hospitalization. Diaphragmatic ultrasound is a useful, non-invasive, and accessible tool for measuring the function of this muscle. Objective: Assessing the morphological and functional ultrasound status of the diaphragm in patients admitted within the first 24 h for COVID-related pneumonia and its association with hospital morbidity and mortality (NCT05805579). Material and methods: Observational, prospective cohort study that included 68 patients admitted for COVID-19 pneumonia with respiratory failure. Diaphragmatic ultrasound was performed within the first 24 h of admission to the pulmonology ward. Clinical, analytical, and ultrasound variables were collected: excursion, thickness, and diaphragmatic shortening fraction (DSF). DSF < 20% was used to define diaphragmatic dysfunction (DD). Patients who showed favorable progression and were managed on the ward (HCONV) were compared to those who required admission to the respiratory monitoring unit (RMU). Results: A total of 68 patients were included, of which 22 (32.35%) were admitted to the RMU. Diaphragmatic excursion at maximum volume was higher in the HCONV group compared to the RMU group (58.41 ± 17.83 vs. 50.03 ± 16.23; p = 0.123). Diaphragmatic dysfunction (DD) was observed in 21 (30.88%) patients, with a higher prevalence in the RMU group than in the HCONV group (15 (68.18%) vs. 6 (13.04%); p = 0.0001). In the multivariate analysis, age and DSF at admission were the best predictors of failure to discharge. Conclusions: Performing diaphragmatic ultrasound to assess mobility and DSF within the first 24 h of admission for COVID-19 pneumonia proves valuable in determining short-term progression and the need for admission to a respiratory monitoring unit.


Introducción: La neumonía por COVID-19 provoca un deterioro de la musculatura diafragmática que influye en la aparición de insuficiencia respiratoria durante la hospitalización del paciente. La ecografía diafragmática es una técnica no invasiva accesible y útil para medir la función de este músculo. Objetivo: Evaluar mediante ecografía el estado funcional y morfológico del diafragma en pacientes con neumonía por COVID durante las primeras 24 h de su ingreso y su asociación con la morbimortalidad intrahospitalaria (NCT05805579). Materiales y métodos: Se realizó un estudio prospectivo y observacional de una cohorte compuesta por 68 pacientes ingresados por neumonía por COVID-19 con insuficiencia respiratoria. La ecografía diafragmática se practicó durante las 24 h siguientes al ingreso en la planta de neumología. Se recopilaron variables clínicas, analíticas y ecográficas: desplazamiento, grosor y fracción de acortamiento diafragmático (FAD). Se utilizó una FAD < 20% como definición de disfunción diafragmática. Se comparó a los pacientes que evolucionaron favorablemente y recibieron tratamiento en planta (hospitalización convencional) con los pacientes que tuvieron que ser ingresados en la unidad de monitorización respiratoria (UMR). Resultados: Se incluyó en el estudio a un total de 68 pacientes, de los cuales 22 ingresaron en la UMR (el 32,35%). El desplazamiento diafragmático con el volumen máximo fue más alto en el grupo de hospitalización convencional que en el grupo ingresado en UMR (58,41 ± 17,83 frente a 50,03 ± 16,23; p = 0,123). Presentaron disfunción diafragmática 21 pacientes (30,88%) y la prevalencia fue más alta en el grupo ingresado en UMR que en el de hospitalización convencional: 15 pacientes (68,18%) frente a 6 (13,04%); p = 0,0001. En el análisis multivariable, la edad y la FAD al ingreso son los factores que mejor predicen la imposibilidad del alta. Conclusiones: La ecografía diafragmática para evaluar la movilidad y la FAD en las primeras 24 h del ingreso por neumonía por COVID-19 resulta valiosa para determinar la evolución a corto plazo y la necesidad de ingreso en una unidad de monitorización respiratoria.

3.
J Behav Addict ; 13(1): 276-292, 2024 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-38217688

RESUMO

Background and aims: The ICD-11 chapter on mental, behavioral and neurodevelopmental disorders contains new controversial diagnoses including compulsive sexual behavior disorder (CSBD), intermittent explosive disorder (IED) and gaming disorder. Using a vignette-based methodology, this field study examined the ability of mental health professionals (MHPs) to apply the new ICD-11 diagnostic requirements for impulse control disorders, which include CSBD and IED, and disorders due to addictive behaviors, which include gaming disorder, compared to the previous ICD-10 guidelines. Methods: Across eleven comparisons, members of the WHO's Global Clinical Practice Network (N = 1,090) evaluated standardized case descriptions that were designed to test key differences between the diagnostic guidelines of ICD-11 and ICD-10. Results: The ICD-11 outperformed the ICD-10 in the accuracy of diagnosing impulse control disorders and behavioral addictions in most comparisons, while the ICD-10 was not superior in any. The superiority of the ICD-11 was particularly clear where new diagnoses had been added to the classification system or major revisions had been made. However, the ICD-11 outperformed the ICD-10 only in a minority of comparisons in which mental health professionals were asked to evaluate cases with non-pathological high involvement in rewarding behaviors. Discussion and Conclusions: Overall, the present study indicates that the ICD-11 diagnostic requirements represent an improvement over the ICD-10 guidelines. However, additional efforts, such as training programs for MHPs and possible refinements of diagnostic guidance, are needed to avoid over-diagnosis of people who are highly engaged in a repetitive and rewarding behavior but below the threshold for a disorder.


Assuntos
Comportamento Aditivo , Transtornos Disruptivos, de Controle do Impulso e da Conduta , Humanos , Classificação Internacional de Doenças , Saúde Mental , Pessoal de Saúde
4.
Healthcare (Basel) ; 12(2)2024 Jan 19.
Artigo em Inglês | MEDLINE | ID: mdl-38275543

RESUMO

The aim of this study was to estimate the level of empathy among primary care (PC) health professionals and its relationship with their approach to patients at risk due to alcohol consumption. This is an observational, descriptive, and multicenter study that included 80 PHC professionals. The professionals completed a questionnaire comprising socio-occupational questions and inquiries regarding their actions when dealing with patients suspected of risky alcohol consumption. The Jefferson Scale of Empathy was used to measure their level of empathy and was completed by 80 professionals, of whom 57.5% were family physicians, 10% were nurses, and 32.5% were family- and community-medicine residents. The mean age was 39.5 ± 13.1 (SD) (range of 24-65 years) and 71.3% were females. The mean empathy level score was 112.9 ± 11.1 (95% CI: 110.4-115.4; range: 81-132 points). Actions that stood out for their frequency were providing health advice in the general population, offering advice to pregnant women, and recommending abstinence to users of hazardous machinery or motor vehicles. The level of empathy was associated with age (p = 0.029), the health center's scope (p = 0.044), systematic alcohol exploration (p = 0.034), and follow-ups for patients diagnosed with risky consumption (p = 0.037). The mean score obtained indicated a high level of empathy among professionals. Professionals with greater empathy more frequently conducted systematic screening for risky alcohol consumption.

5.
Salud Publica Mex ; 65(4, jul-ago): 402-406, 2023 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-38060894

RESUMO

OBJECTIVE: To update prior studies on the impact of Covid-19 on suicide in Mexico. MATERIALS AND METHODS: We used interrupted time-series analysis to model the national trend in monthly suicides before Covid-19 (January 1, 2010, to March 31, 2020), comparing the expected number of suicides with the observed number for the remainder of the period (April 1, 2020, to December 31, 2021). RESULTS: We observed a 5% increase in suicides, driven by suicides among the younger females ages <44 years and among older males ages 45+. CONCLUSION: Since in Mexico the impact of Covid-19 on suicide depended on sex and age, tailored public health strategies may be needed to confront the problem.


Assuntos
COVID-19 , Suicídio , Masculino , Feminino , Humanos , México/epidemiologia , COVID-19/epidemiologia , Saúde Pública
6.
Rev. esp. quimioter ; 36(5): 477-485, oct. 2023. tab
Artigo em Espanhol | IBECS | ID: ibc-225883

RESUMO

Objetivo. Determinar el grado de aceptación de un Pro grama de Optimización del Uso de Antimicrobianos (PROA) en un Servicio de Medicina Intensiva (SMI), y evaluar su efecto sobre el consumo de antibióticos, indicadores de calidad y re sultados clínicos. Pacientes y métodos. Descripción retrospectiva de las intervenciones propuestas por un PROA. Comparación de uso de antimicrobianos, indicadores de calidad y seguridad frente a un periodo sin PROA. Se realizó en un SMI polivalente de un Hospital Universitario mediano (600 camas). Se estudió a pacientes ingresados por cualquier causa en el SMI durante el periodo PROA en los que se hubiera obtenido una muestra di rigida al diagnóstico de una potencial infección, o se hubieran iniciado antimicrobianos. Se elaboraron recomendaciones no impositivas para mejorar la prescripción antimicrobiana (es tructura audit and feedback) y se procedió a su registro du rante periodo PROA (15 meses, octubre 2018–diciembre 2019). Comparación de indicadores en un periodo con PROA (abril– junio 2019) y sin PROA (abril–junio 2018). Resultados. Se emitieron 241 recomendaciones sobre 117 pacientes, el 67% de ellas de tipo desescalada terapéutica. La aceptación de las recomendaciones fue elevada (96.3%). En el periodo PROA se redujo el número medio de antibióticos por paciente (3.3±4.1 vs 2.4±1.7, p=0.04) y los días de tratamiento (155 DOT/100 PD vs 94 DOT/100 PD, p <0.01) (AU)


Objective. We aim to evaluate the adherence rate to an Antimicrobial Stewardship Program (ASP) in an Intensive Care Unit (ICU), and to assess its effect on the use of antibiotics, quality indicators and clinical outcomes. Patients and methods. Retrospective description of the interventions proposed by the ASP. We compared antimi crobial use, quality and safety indicators in an ASP versus a non-ASP period. The study was performed in a polyvalent ICU of a medium-size University Hospital (600 beds). We studied patients admitted to the ICU for any cause during the ASP pe riod, provided that a microbiological sample aiming to diag nose a potential infection has been drawn, or antibiotics have been started. We elaborated and registered of non-mandatory recommendations to improve antimicrobial prescription (audit and feedback structure) and its registry during the ASP peri od (15 months, October 2018-December 2019). We compared indicators in a period with ASP (April-June 2019) and without ASP (April-June 2018). Results. We issued 241 recommendations on 117 pa tients, 67% of them classified as de-escalation type. The rate of adherence to the recommendations was high (96.3%). In the ASP period, the mean number of antibiotics per patient (3.3±4.1 vs 2.4±1.7, p=0.04) and the days of treatment (155 DOT/100 PD vs 94 DOT/100 PD, p <0.01) (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Gestão de Antimicrobianos , Unidades de Terapia Intensiva , Resistência Microbiana a Medicamentos , Cuidados Críticos , Estudos Retrospectivos
7.
Molecules ; 28(15)2023 Jul 25.
Artigo em Inglês | MEDLINE | ID: mdl-37570613

RESUMO

The present study reports on a 2D lamellar coordination polymer (CP) of {[Zn(µ3-pmdc)(H2O)]·H2O}n formula (pmdc = pyrimidine-4,6-dicarboxylate). This CP is synthesized under an appropriate acid-base reaction between the gently mortared reagents in the solid state through a solvent-free procedure that avoids the presence of concomitant byproducts. The X-ray crystal structure reveals the occurrence of Zn2 entities connected through carboxylate groups of pmdc, which behave as triconnected nodes, giving rise to six-membered ring-based layers that are piled up through hydrogen bonding interactions. In addition to a routine physico-chemical characterization, the thermal evolution of the compound has been studied by combining thermogravimetric and thermodiffractometric data. The photoluminescence properties are characterized in the solid state and the processes governing the spectra are described using time-dependent density-functional theory (TD-DFT) with two different approaches employing different program packages. The emissive capacity of the material is further analyzed according to the dehydration and decreasing temperature of the polycrystalline sample.

9.
Acta otorrinolaringol. esp ; 74(3): 192-197, Mayo - Junio 2023. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-220821

RESUMO

El carcinoma metastásico cervical de primario de origen desconocido (CPD) a las cadenas ganglionares linfáticas cervicales representa menos del 5% de todas las neoplasias malignas de cabeza y cuello. Publicaciones recientes avalan el uso de la cirugía transoral durante el proceso diagnóstico, a su vez la cirugía ultrasónica endoscópica transoral representa una alternativa técnica recientemente descrita. Se realizó un estudio piloto para evaluar la viabilidad de la mucosectomía transoral ultrasónica de la base de lengua (BDL) y la amigdalectomía bilateral en el diagnóstico de CPD. Se incluyeron 10 pacientes de forma consecutiva. En 2 casos (20%) se encontró el primario, uno en amígdala palatina derecha y otro en la BDL izquierda. De acuerdo con nuestros resultados, la cirugía ultrasónica transoral representa una técnica útil al momento de realizar una mucosectomía de la BDL, así como la amigdalectomía bilateral durante el proceso diagnóstico en pacientes con CPD. (AU)


Metastatic carcinoma of unknown primary (CUP) to cervical lymph nodes represents less than 5% of all head and neck malignancies. Recent publications support the use of transoral surgery during the diagnosis work-up, and transoral endoscopic ultrasonic surgery represents a recently described alternative technique in transoral surgery. A pilot study to assess the feasibility of trans-oral ultrasonic base of tongue (BOT) mucosectomy and bilateral tonsillectomy approach in CUP diagnosis work-up was conducted. Ten patients were included consecutively. In two cases (20%) the primary was found, in one case in the right tonsil, and another one in the left BOT. According to our results, the use of trans-oral ultrasonic surgery to perform the base of tongue mucosectomy and bilateral tonsillectomy in CUP patient's during the diagnosis work-up represents an effective option in patients with good anatomical exposure. (AU)


Assuntos
Humanos , Cirurgia Geral , Tonsilectomia , Endoscopia/instrumentação , Endoscopia/métodos , Neoplasias de Cabeça e Pescoço/cirurgia , Neoplasias de Cabeça e Pescoço/terapia
12.
J Clin Med ; 12(6)2023 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-36983274

RESUMO

BACKGROUND: Cardiac amyloidosis (CA) could be a common cause of heart failure (HF). The objective of the study was to estimate the prevalence of CA in patients with HF. METHODS: Observational, prospective, and multicenter study involving 30 Spanish hospitals. A total of 453 patients ≥ 65 years with HF and an interventricular septum or posterior wall thickness > 12 mm were included. All patients underwent a 99mTc-DPD/PYP/HMDP scintigraphy and monoclonal bands were studied, following the current criteria for non-invasive diagnosis. In inconclusive cases, biopsies were performed. RESULTS: The vast majority of CA were diagnosed non-invasively. The prevalence was 20.1%. Most of the CA were transthyretin (ATTR-CM, 84.6%), with a minority of cardiac light-chain amyloidosis (AL-CM, 2.2%). The remaining (13.2%) was untyped. The prevalence was significantly higher in men (60.1% vs 39.9%, p = 0.019). Of the patients with CA, 26.5% had a left ventricular ejection fraction less than 50%. CONCLUSIONS: CA was the cause of HF in one out of five patients and should be screened in the elderly with HF and myocardial thickening, regardless of sex and LVEF. Few transthyretin-gene-sequencing studies were performed in older patients. In many patients, it was not possible to determine the amyloid subtype.

13.
Rev. senol. patol. mamar. (Ed. impr.) ; 36(1): 1-6, ene.-mar. 2023. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-215276

RESUMO

Introducción: el empleo de dispositivos de tomografía por emisión de positrones mamodedicados (dbPET) mejora la resolución espacial respecto a la PET corporal total. La mamografía mediante imagen molecular PET (MAMMI-PET) es una nueva técnica, pero los estudios clínicos realizados son escasos. El objetivo del trabajo es determinar la sensibilidad, especificidad, los valores predictivos positivos y negativos de la MAMMI-PET, así como comparar el dispositivo con las pruebas de imagen tradicionales. Material y métodos: estudio observacional prospectivo y analítico sobre una muestra de pacientes con cáncer de mama confirmado histológicamente, atendidas en el Hospital General de Valencia (enero 2017-noviembre 2018). Se realizó un estudio preoperatorio con ecografía, mamografía, resonancia magnética nuclear y MAMMI-PET. Se consideró a la anatomía patológica como el patrón oro del número y tipo de lesiones existentes en cada mama. Se comprobó si el diagnóstico del MAMMI-PET para cada lesión coincidió con el resultado de la anatomía patológica. Se comparó la sensibilidad de cada prueba con la del MAMMI-PET empleando la prueba de Chi cuadrado con nivel de significación de 0,05. Resultados: se evaluaron los datos de 32 pacientes y 44 lesiones (36 malignas y 8 benignas). Dos pacientes fueron excluidas del estudio. Se obtuvo una sensibilidad del 75% para el MAMMI-PET. La mejor sensibilidad se obtuvo para la resonancia magnética nuclear con 85,3% mientras que para la ecografía y la mamografía fue de 77,8 y 69,4%, respectivamente. No se evidenciaron diferencias estadísticamente significativas en el estudio comparativo entre el MAMMI-PET y el resto de las pruebas de imagen. Conclusiones: la sensibilidad del MAMMI-PET (75%) para el diagnóstico de cáncer de mama fue similar a las otras pruebas de imagen. (AU)


Introduction: The use of mammo dedicated breast PET (dbPET) scanners improves spacial resolution compared to Whole Body Pet images (WBPET). Mammography with Molecular Imaging PET (MAMMI-PET) is a new device with hardly any clinical studies. The aim of the study is to estimate the sensitivity of MAMMI-PET and compare it with classic imaging devices. Material and methods: A prospective and analytical observational study was carried out in a sample of patients with histologically confirmed breast cancer who were treated at our hospital between January 2017 and November 2018. Preoperative study of patients was performed with ultrasound, mammography, Magnetic Resonance Imaging (MRI) and MAMMI-PET. Findings (number and benignant/malignant lesions) of the anatomopathological (AP) study were used as the gold standard. Results between MAMMI-PET and AP were compared. The sensitivity of each test was compared with that of the MAMMI-PET using the Chi square test with a significance level of 0.05. Results: Data from 32 patients and 44 lesions (36 malignant and 8 benign) were evaluated. Two patients were excluded. The MAMMI-PET sensitivity was 75%. The best sensitivity was obtained for MRI with 85.3%, while for ultrasound and mammography it was 77.8% and 69.4% respectively. No statistically significant differences were found between the sensitivity of MAMMIPET and the rest of the imaging tests. Conclusions: The sensitivity obtained for the MAMMI-PET scanner (75%) was similar to the other imaging tests. (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Neoplasias da Mama/diagnóstico por imagem , Mamografia , Imageamento por Ressonância Magnética , Estudos Prospectivos , Hospitais Gerais
14.
Neuropsychopharmacol Rep ; 43(1): 12-22, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-36727594

RESUMO

BACKGROUND: Although alcohol use disorder is a complex human pathology, the use of animal models represents an opportunity to study some aspects of this pathology. One of the most used paradigms to study the voluntary alcohol consumption in rodents is operant self-administration (OSA). AIMS: In order to facilitate the performance of this paradigm, we aim to describe some critical steps of OSA under a saccharin-fading procedure. MATERIAL & METHODS: We used 40 male Wistar rats to study the process of acquiring the operant response through a saccharin-fading procedure under a fixed ratio (FR1) schedule of reinforcement. Next, we analyze the alcohol introduction and concentration increase, the effect of an alcohol deprivation, and the analogy between this paradigm with the Drinking in the Dark-Multiple Scheduled Access paradigm. RESULTS: During alcohol concentration increase, animals reduced their lever presses in accordance with the increase in alcohol concentration. On the contrary, the consumption measured in g·kg-1 BW showed a great stability. The lever presses pattern within operant session changes with the introduction of different alcohol concentrations: at higher alcohol concentrations, animals tended to accumulate most of their presses in the initial period of the session. DISCUSSION: We show the utility of fading with low concentrations of saccharin and the evolution of the operant response through the different concentrations of alcohol. CONCLUSION: Taken together, our results aimed to dissect the acquisition and maintenance of OSA behavior as well as other related variables, to facilitate the understanding and performance of this paradigm.


Assuntos
Etanol , Sacarina , Animais , Humanos , Masculino , Ratos , Condicionamento Operante/fisiologia , Ratos Wistar , Sacarina/farmacologia , Autoadministração
15.
Med Microbiol Immunol ; 212(1): 93-102, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36595027

RESUMO

Measurement of anti-pneumococcal capsular polysaccharides (anti-PnPs) IgG titers is an important tool in the immunologic assessment of patients with suspected immunodeficiency disorders (ID) to reduce the morbi-mortality and minimize severe infections. Retrospectively, we studied the relationship among anti-PnPs IgG response to 3 doses of Prevenar®13, levels of immune system components, leukocyte populations, and clinical data in children with ID. Serum samples were collected at least 4 weeks post vaccination. Subsequently, multi-serotype enzyme-linked immunosorbent assay (ELISA) was performed. Eighty-seven children (under 12 years) were enrolled. Primary immunodeficiency disorder (PID) was the most common disorder (45) followed by possible immunodeficiency disorder (POID) (19), secondary immunodeficiency disorder (SID) (15), and mixed immunodeficiency disorder (MID) (8). The median age was 3 (1.50-5.33) years, 65% of patients were male. Deficient production of anti-PnPs IgG (titer ≤ 50 mg/L) was detected in 47 patients (54%), especially in the MID group, all of them under immunosuppressive therapy. In PCV13 responders, the mean of leukocyte population levels was higher with statistically significance differences in CD4 + /CD8 + T lymphocytes (p = 0.372, p = 0.014) and CD56 + /CD16 + NK (p = 0.016). Patients with previous bone marrow transplantation were the worst PCV13 responders. Pneumococcal IgG antibody titers (post-vaccination) along with clinical and analytical markers represented.


Assuntos
Formação de Anticorpos , Vacinas Pneumocócicas , Pré-Escolar , Feminino , Humanos , Masculino , Anticorpos Antibacterianos , Vacina Pneumocócica Conjugada Heptavalente , Imunoglobulina G , Estudos Retrospectivos , Streptococcus pneumoniae , Lactente
16.
Eur Arch Otorhinolaryngol ; 280(2): 869-876, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36102986

RESUMO

INTRODUCTION: Nowadays, 70% of patients in Europe and the USA are affected by a p16 + , potentially HPV driven oropharyngeal squamous cell carcinoma. However, despite the improved survival rate in this group, the quality-of-life remains low in cases which neck dissection took place. In this vein, in recent years, some surgeons have considered to avoid dissection of level IIB, proposing a supra-selective non-IIb neck dissection. MATERIALS AND METHODS: A retrospective, longitudinal, multicentric study was conducted, including patients with pathologically confirmed primary HPV + or HPV - OPSCC who went through surgical treatment for the primary lesion and neck dissection. RESULTS: 141 patients were included. Among them, 99 (70.2%) were male and 42 (29.8%) were female. The mean age was 62 ± 9 years (range 36-81). The most frequent anatomical location was the tonsil in 63 (44.7%) of patients. The most common approach was the classic transoral oropharyngectomy in 51 (36.2%) patients. Immunohistochemistry for p16 was positive in 62 (44%) patients. One-hundred and five (74.5%) patients received a unilateral ND, and a 36 (25.5%) a bilateral ND. Of those, a 12.8% (18/141) of patients were level IIb LN + . According to our results, level IIb ND should be considered in patients underwent therapeutic ND with positive LN metastasis in level IIa (OR = 9.83; 95% CI 3.463-27.917) or III (OR = 6.25; 95% CI 2.158-18.143), advanced (T3/T4) oropharyngeal primary tumors (OR = 3.38; 95% CI 1.366-8.405), and patients with ENE (OR = 6.56; 95% CI 2.182-19.770), regardless of p16 status. CONCLUSIONS: According to our results, level IIb ND should be considered in patients who underwent therapeutic ND with positive LN metastasis in level IIa or III, advanced oropharyngeal primary tumors, and patients with ENE, independently of p16 status. Prospective data are necessary to definitively ensure the safety of omitting ipsilateral or contralateral level IIb ND in cN - patients with early stage disease.


Assuntos
Neoplasias Orofaríngeas , Infecções por Papillomavirus , Carcinoma de Células Escamosas de Cabeça e Pescoço , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Linfonodos/patologia , Metástase Linfática/patologia , Esvaziamento Cervical/métodos , Estadiamento de Neoplasias , Neoplasias Orofaríngeas/patologia , Neoplasias Orofaríngeas/cirurgia , Infecções por Papillomavirus/patologia , Estudos Prospectivos , Estudos Retrospectivos , Carcinoma de Células Escamosas de Cabeça e Pescoço/cirurgia , Carcinoma de Células Escamosas de Cabeça e Pescoço/patologia
17.
Artigo em Inglês | MEDLINE | ID: mdl-36241027

RESUMO

Metastatic carcinoma of unknown primary (CUP) to cervical lymph nodes represents less than 5% of all head and neck malignancies. Recent publications support the use of transoral surgery during the diagnosis work-up, and transoral endoscopic ultrasonic surgery represent a recently described alternative technique in transoral surgery. A pilot study to assess the feasibility of trans-oral ultrasonic base of tongue (BOT) mucosectomy and bilateral tonsillectomy approach in CUP diagnosis work-up was conducted. Ten patients were included consecutively. In 2 cases (20%) the primary was found, in one case in the right tonsil, and another one in the left BOT. According to our results, the use of trans-oral ultrasonic surgery to perform the base of tongue mucosectomy and bilateral tonsillectomy in CUP patient's during the diagnosis work-up represents an effective option in patients with good anatomical exposure.


Assuntos
Carcinoma , Cirurgia Endoscópica por Orifício Natural , Neoplasias Primárias Desconhecidas , Procedimentos Cirúrgicos Robóticos , Procedimentos Cirúrgicos Ultrassônicos , Humanos , Neoplasias Primárias Desconhecidas/cirurgia , Neoplasias Primárias Desconhecidas/etiologia , Neoplasias Primárias Desconhecidas/patologia , Ultrassom , Projetos Piloto , Procedimentos Cirúrgicos Robóticos/métodos , Cirurgia Endoscópica por Orifício Natural/métodos
18.
Neural Regen Res ; 18(3): 503-505, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36018154

RESUMO

Neurodegeneration affects a large number of cell types including neurons, astrocytes or oligodendrocytes, and neural stem cells. Neural stem cells can generate new neuronal populations through proliferation, migration, and differentiation. This neurogenic potential may be a relevant factor to fight neurodegeneration and aging. In the last years, we can find growing evidence suggesting that melatonin may be a potential modulator of adult hippocampal neurogenesis. The lack of therapeutic strategies targeting neurogenesis led researchers to explore new molecules. Numerous preclinical studies with melatonin observed how melatonin can modulate and enhance molecular and signaling pathways involved in neurogenesis. We made a special focus on the connection between these modulation mechanisms and their implication in neurodegeneration, to summarize the current knowledge and highlight the therapeutic potential of melatonin.

20.
Nanomaterials (Basel) ; 12(22)2022 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-36432263

RESUMO

The work presented herein reports on the synthesis, structural and physico-chemical characterization, luminescence properties and luminescent sensing activity of a family of isostructural coordination polymers (CPs) with the general formula [Ln2(µ4-5Meip)3(DMF)]n (where Ln(III) = Sm (1Sm), Eu (2Eu), Gd (3Gd), Tb (4Tb) and Yb (5Yb) and 5Meip = 5-methylisophthalate, DMF = N,N-dimethylmethanamide). Crystal structures consist of 3D frameworks tailored by the linkage between infinite lanthanide(III)-carboxylate rods by means of the tetradentate 5Meip ligands. Photoluminescence measurements in solid state at variable temperatures reveal the best-in-class properties based on the capacity of the 5Meip ligand to provide efficient energy transfers to the lanthanide(III) ions, which brings intense emissions in both the visible and near-infrared (NIR) regions. On the one hand, compound 5Yb displays characteristic lanthanide-centered bands in the NIR with sizeable intensity even at room temperature. Among the compounds emitting in the visible region, 4Tb presents a high QY of 63%, which may be explained according to computational calculations. At last, taking advantage of the good performance as well as high chemical and optical stability of 4Tb in water and methanol, its sensing capacity to detect 2,4,6-trinitrophenol (TNP) among other nitroaromatic-like explosives has been explored, obtaining high detection capacity (with Ksv around 105 M-1), low limit of detection (in the 10-6-10-7 M) and selectivity among other molecules (especially in methanol).

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