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1.
Sci Total Environ ; 808: 152164, 2022 Feb 20.
Artigo em Inglês | MEDLINE | ID: mdl-34875333

RESUMO

The sedimentary processes play a major role in every aquatic ecosystem, however, there are few automated options for in-situ monitoring of sediment displacement in the streambed of waterways. We present an automated optical instrument for in-situ continuous monitoring of sediment deposition and erosion of the streambed that requires no calibration. With a production cost of 32€, power consumption of 300 µA in sleep mode, and capacity to monitor the bedform of a waterway, the sensor was developed to evaluate the sediment dynamics of coastal areas with a wide spatial and temporal resolution. The novel device is intended to be buried in the sand and uses 32 infrared channels to monitor the streambed sediment height. For testing purposes, a maximum measuring length of 160 mm and 5 mm resolution was chosen, but these values are scalable. Sensors can be built with different ranges and precision according to the needs of the fieldwork. A laboratory experiment was conducted to demonstrate the working principle of the instrument and its behaviour regarding the turbidity originated by suspended sediment and the settling and deposition of the suspended particles. The device was deployed for 119 days in an estuarine area and was able to detect patterns in the sediment deposition and resuspension during the tidal cycles. Also, abnormal events occurred during the experiment as floods and algae blooms. During these events, the sensor was able to record exceptional erosion and sediment deposition rates. The reported automated instrument can be broadly used in sedimentary studies or management and planning of fluvial and maritime infrastructures to provide real-time information about the changes in the bedform of the watersheds.


Assuntos
Monitoramento Ambiental , Sedimentos Geológicos , Ecossistema , Inundações
2.
Int. j. odontostomatol. (Print) ; 14(2): 167-171, June 2020. graf
Artigo em Inglês | LILACS | ID: biblio-1090670

RESUMO

The naso-orbito-ethmoidal region is composed of delicate bones and when fractured may result in significant aesthetic-functional impairment. Diagnosis through clinical and imaging findings is extremely important for surgical planning. This study aims to report a case of type III fracture of the naso-orbito-ethmoidal region. Patient D.R.S., female, 13 years old, attended the emergency department of Hospital dos Fornecedores de Cana de Piracicaba (HFCP) - SP with complaint of pain in the fronto-nasal region and respiratory distress after trauma in face of baseball bat. Physical examination showed edema and short blunt injury in the region of the nasal dorsum and frontal region, bilateral periorbital hematoma, hyposphagma in right eye and traumatic telecanthus. When analyzing the computed tomography, it was observed fracture of the nasal bones, also affecting the medial wall of the orbit. The procedure was osteosynthesis of the fractures and reconstruction of the nasal dorsum. The fracture traces were exposed from coronal access, reduction of fractures and use of calvarial bone graft for nasal dorsum reconstruction. The fracture and the graft were fixed with plates of 1,6mm. Postoperative computed tomography analysis showed good graft positioning, but there was still a slight sinking of the left lateral wall of the nose. In a second moment another surgical intervention was done to reduce this wall and an internal containment device was installed. Currently the patient is in a state of observation and a follow-up period of 665 days. In cases of complex nasoorbito-ethmoidal fractures early diagnosis and treatment is essential to minimize sequelae and provide a better aesthetic and functional result.


La región etmoidal nasoorbital está compuesta de huesos delicados y, cuando se fractura, puede provocar una lesión estética-funcional significativa. El diagnóstico mediante hallazgos clínicos y de imagen es de suma importancia para la planificación quirúrgica. El paciente D.R.S., mujer, 13 años, leucoderma, asistió al servicio de emergencia del Hospital de Proveedores de Caña de Azúcar de Piracicaba quejándose de dolor en la región frontal-nasal y dificultad para respirar después de un traumatismo en la cara con un palo. El examen físico reveló edema y lesión contundente en el dorso nasal y la región frontal, hematoma periorbitario bilateral, hiposfagma del ojo derecho y telecanto traumático. Al analizar la tomografía computarizada se observó fractura de los huesosnasales en libro abierto, afectando también la pared medial de la órbita. El enfoque aplicado fue la osteosíntesis de fracturas y la reconstrucción del dorso nasal. Los rastros de fractura se expusieron del abordaje coronal, se redujeron las fracturas y se usaron injertos de casquete para reconstruir el dorso nasal. La fractura y el injerto se fijaron con placas de sistema de 1,6 mm y se realizó la cantopexia de los ligamentos cantales mediales. Se requirió cirugía reparadora secundaria para la corrección de la pared lateral de la nariz, que persistió en el postoperatorio. Actualmente el paciente se encuentra en un estado de conservación y período de seguimiento de 665 días. En casos de fracturas nasoorbitales-etmoidales complejas, el diagnóstico y el tratamiento tempranos son esenciales para minimizar las secuelas y proporcionar un mejor resultado estético y funcional.


Assuntos
Humanos , Feminino , Adolescente , Fraturas Cranianas/cirurgia , Osso Etmoide/cirurgia , Redução Aberta/métodos , Osso Nasal/cirurgia , Fraturas Orbitárias/cirurgia , Fraturas Cranianas/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Osso Etmoide/lesões , Fixação de Fratura , Osso Nasal/lesões
3.
J Physiol Biochem ; 74(4): 579-589, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29790117

RESUMO

The main aim of this investigation was to study the regulatory roles of let-7b and miR-155-3p on the expression of inflammation-associated genes in monocytes, macrophages, and lipopolysaccharide (LPS)-activated macrophages (AcM). A second goal was to analyze the potential modulatory roles of different fatty acids, including oleic, palmitic, eicosapentaenoic (EPA), and docosahexaenoic (DHA), on the expression of these miRNAs in the three cell types. This hypothesis was tested in human acute monocytic leukemia cells (THP-1), which were differentiated into macrophages with 2-O-tetradecanoylphorbol-13-acetate (TPA) and further activated with LPS for 24 h. Monocytes, macrophages, and AcM were transfected with a negative control, or mimics for miR-155-3p and miR-let-7b-5p. The expression of both miRNAs and some proinflammatory genes was analyzed by qRT-PCR. Interestingly, let-7b mimic reduced the expression of IL6 and TNF in monocytes, and SERPINE1 expression in LPS-activated macrophages. However, IL6, TNF, and SERPINE1 were upregulated in macrophages by let-7b mimic. IL6 expression was higher in the three types of cells after transfecting with miR-155-3p mimic. Similarly, expression of SERPINE1 was increased by miR-155-3p mimic in monocytes and macrophages. However, TLR4 was downregulated by miR-155-3p in monocytes and macrophages. Regarding the effects of the different fatty acids, oleic acid increased the expression of let-7b in macrophages and AcM and also increased the expression of miR-155 in monocytes when compared with DHA but not when compared with non-treated cells. Overall, these results suggest anti- and proinflammatory roles of let-7b and miR-155-3p in THP-1 cells, respectively, although these outcomes are strongly dependent on the cell type. Noteworthy, oleic acid might exert beneficial anti-inflammatory effects in immune cells (i.e., non-activated and LPS-activated macrophages) by upregulating the expression of let-7b.


Assuntos
Ácidos Graxos não Esterificados/metabolismo , Regulação da Expressão Gênica , Macrófagos/metabolismo , MicroRNAs/metabolismo , Monócitos/metabolismo , Diferenciação Celular/efeitos dos fármacos , Ácidos Docosa-Hexaenoicos/metabolismo , Regulação para Baixo , Regulação da Expressão Gênica/efeitos dos fármacos , Humanos , Interleucina-6/agonistas , Interleucina-6/antagonistas & inibidores , Interleucina-6/genética , Interleucina-6/metabolismo , Lipopolissacarídeos/toxicidade , Ativação de Macrófagos/efeitos dos fármacos , Macrófagos/efeitos dos fármacos , Macrófagos/imunologia , MicroRNAs/química , Monócitos/imunologia , Ácido Oleico/metabolismo , Inibidor 1 de Ativador de Plasminogênio/agonistas , Inibidor 1 de Ativador de Plasminogênio/química , Inibidor 1 de Ativador de Plasminogênio/genética , Inibidor 1 de Ativador de Plasminogênio/metabolismo , RNA/metabolismo , Células THP-1 , Acetato de Tetradecanoilforbol/farmacologia , Receptor 4 Toll-Like/antagonistas & inibidores , Receptor 4 Toll-Like/genética , Receptor 4 Toll-Like/metabolismo , Fator de Necrose Tumoral alfa/agonistas , Fator de Necrose Tumoral alfa/antagonistas & inibidores , Fator de Necrose Tumoral alfa/genética , Fator de Necrose Tumoral alfa/metabolismo
4.
Rev Gastroenterol Mex ; 82(2): 134-155, 2017.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-28318706

RESUMO

This is the first Latin American Consensus of the Pan American Crohn's and Colitis Organisation (PANCCO) regarding special situations in patients with inflammatory bowel disease (IBD). The aim of this consensus is to raise awareness in the medical community in all Latin American countries with respect to pregnancy, vaccinations, infections, neoplasms, including colorectal cancer, and pediatric issues in patients with IBD.


Assuntos
Doenças Inflamatórias Intestinais/terapia , Adulto , Criança , Colite Ulcerativa/complicações , Colite Ulcerativa/terapia , Consenso , Doença de Crohn/complicações , Doença de Crohn/terapia , Feminino , Humanos , Doenças Inflamatórias Intestinais/complicações , América Latina , Masculino , Gravidez
5.
Rev Gastroenterol Mex ; 82(1): 46-84, 2017.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-27979414

RESUMO

The incidence and prevalence of inflammatory bowel disease (IBD) has increased in recent years in several Latin American countries. There is a need to raise awareness in gastroenterologists and the population in general, so that early diagnosis and treatment of ulcerative colitis (UC) and Crohn's Disease (CD) can be carried out. It is important for all physicians to have homogeneous criteria regarding the diagnosis and treatment of IBD in Latin America. The Pan American Crohn's and Colitis Organisation (PANCCO) is an organization that aims to include all the countries of the Americas, but it specifically concentrates on Latin America. The present Consensus was divided into two parts for publication: 1) Diagnosis and treatment and 2) Special situations. This is the first Latin American Consensus whose purpose is to promote a perspective adapted to our Latin American countries for the diagnosis, treatment, and monitoring of patients with UC and CD.


Assuntos
Colite Ulcerativa/diagnóstico , Colite Ulcerativa/terapia , Doença de Crohn/diagnóstico , Doença de Crohn/terapia , Colite Ulcerativa/complicações , Doença de Crohn/complicações , Humanos , América Latina
7.
Phlebology ; 28(8): 441-4, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-23188814

RESUMO

OBJECTIVE: To assess the presence of pulmonary embolism and inflammation after polidocanol foam injection into the peripheral veins of rabbits. METHOD: The animals were treated with polidocanol foam (1 or 3 mg/kg) or vehicle. Early (15 minutes) and late (30 days) animals were evaluated by perfusional lung scintigraphy and histopathological examination. RESULTS: In the control group no alterations were found. After polidocanol foam injection it was observed that an important reduction of pulmonary perfusion in the early periods, was mainly in the left lung (P < 0.001), with consequent embolism in the histological evaluation. In late periods it was observed that the presence of thrombus was with fibrin in small veins, compatible with chronic thrombus and the presence of chronic pulmonary inflammation. CONCLUSIONS: The injection of polidocanol foam in experimental animals can induce venous embolism and chronic inflammatory infiltration.


Assuntos
Pulmão/irrigação sanguínea , Pulmão/patologia , Polietilenoglicóis/efeitos adversos , Embolia Pulmonar/induzido quimicamente , Embolia Pulmonar/patologia , Soluções Esclerosantes/efeitos adversos , Doença Aguda , Animais , Doença Crônica , Feminino , Masculino , Polidocanol , Polietilenoglicóis/farmacologia , Coelhos , Soluções Esclerosantes/farmacologia , Fatores de Tempo
8.
Nutr Hosp ; 27(5): 1460-8, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-23478692

RESUMO

BACKGROUND: In Brazil, a mixture of cereals known as "Human Ration" (HR) has been consumed as a substitute for meals due to effects in satiation and weight loss. METHODS: This paper evaluated the effect of HR consumption for 45 days as a breakfast replacement, on body composition, biochemical profile and eating behavior in women (n = 20) between 18-45 years old and with BMI between 27-35 kg/m². RESULTS: The intake of HR did not promote significant changes in the body composition as well as in the mean serum values of glucose, HDL, VLDL, TC/HDL, AST and ALT. However, a significant change was noticed in the levels of TC, LDL and triglycerides (p < 0.05). Average daily intake of calories and macronutrients of the volunteers during the period of HR consumption did not differ from their habitual ingestion (p > 0.05). Regarding the consumption of total fibers, there was a significant increase (p < 0.05) in intake at breakfast during the period of HR consumption when compared to the usual intake. The consumption of HR did not intervene in the sensations of satiation, hunger and prospective intake among the subjects, presenting only instantaneous significant alterations throughout the study. CONCLUSION: The results are clinically relevant, since they may contribute to the reduction of risk factors for chronic noncommunicable diseases.


Assuntos
Composição Corporal/fisiologia , Peso Corporal/fisiologia , Grão Comestível , Lipídeos/sangue , Sobrepeso/sangue , Sobrepeso/dietoterapia , Adolescente , Adulto , Antropometria , Desjejum , Dieta , Feminino , Humanos , Estudos Longitudinais , Pessoa de Meia-Idade , Atividade Motora , Adulto Jovem
10.
Anim Genet ; 41(1): 39-47, 2010 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-19799596

RESUMO

Bioinformatics and re-sequencing approaches were used for the discovery of sequence polymorphisms in Litopenaeus vannamei. A total of 1221 putative single nucleotide polymorphisms (SNPs) were identified in a pool of individuals from various commercial populations. A set of 211 SNPs were selected for further molecular validation and 88% showed variation in 637 samples representing three commercial breeding lines. An association analysis was performed between these markers and several traits of economic importance for shrimp producers including resistance to three major viral diseases. A small number of SNPs showed associations with test weekly gain, grow-out survival and resistance to Taura Syndrome Virus. Very low levels of linkage disequilibrium were revealed between most SNP pairs, with only 11% of SNPs showing an r(2)-value above 0.10 with at least one other SNP. Comparison of allele frequencies showed small changes over three generations of the breeding programme in one of the commercial breeding populations. This unique SNP resource has the potential to catalyse future studies of genetic dissection of complex traits, tracing relationships in breeding programmes, and monitoring genetic diversity in commercial and wild populations of L. vannamei.


Assuntos
Variação Genética , Penaeidae/genética , Polimorfismo de Nucleotídeo Único , Animais , Etiquetas de Sequências Expressas , Frequência do Gene , Genética Populacional , Desequilíbrio de Ligação
13.
Peptides ; 28(7): 1375-82, 2007 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-17629353

RESUMO

In the present study, we evaluated the involvement of the rennin-angiotensin system (RAS) in the control of the blood pressure (BP), baroreceptor-mediated bradycardia and the reactivity of caudal ventrolateral medulla (CVLM) neurons to Ang II and to AT(2) receptor antagonist in sedentary or trained renovascular hypertensive rats. Physical activity did not significantly change the baseline mean arterial pressure (MAP), heart rate (HR) or the sensitivity of the baroreflex bradycardia in normotensive Sham rats. However, in 2K1C hypertensive rats, physical activity induced a significant fall in baseline MAP and HR and produced an improvement of the baroreflex function (bradycardic component). The microinjections of Ang II into the CVLM produced similar decreases in MAP in all groups, Sham and 2K1C, sedentary and trained rats. The hypotensive effect of Ang II at the CVLM was blocked by previous microinjection of the AT(2) receptors antagonist, PD123319, in all groups of rats. Unexpectedly, microinjection of PD123319 at the CVLM produced a depressor effect in 2K1C sedentary that was attenuated in 2K1C trained rats. No significant changes in MAP were observed after PD123319 in Sham rats, sedentary or trained. These data showed that low-intensity physical activity is effective in lowering blood pressure and restoring the sensitivity of the baroreflex bradycardia, however these cardiovascular effects are not accompanied by changes in the responsiveness to Ang II at CVLM in normotensive or hypertensive, 2K1C rats. In addition, the blood pressure changes observed after AT(2) blockade in 2K1C rats suggest that hypertension may trigger an imbalance of AT(1)/AT(2) receptors at the CVLM that may be restored, at least in part, by low-intensity physical activity.


Assuntos
Hipertensão Renovascular/fisiopatologia , Bulbo/fisiopatologia , Receptor Tipo 2 de Angiotensina/fisiologia , Angiotensina II/administração & dosagem , Angiotensina II/farmacologia , Bloqueadores do Receptor Tipo 2 de Angiotensina II , Animais , Barorreflexo/efeitos dos fármacos , Pressão Sanguínea/efeitos dos fármacos , Bradicardia/fisiopatologia , Frequência Cardíaca/efeitos dos fármacos , Imidazóis/administração & dosagem , Microinjeções , Neurônios/fisiologia , Condicionamento Físico Animal , Piridinas/administração & dosagem , Ratos , Ratos Endogâmicos SHR , Sistema Renina-Angiotensina , Sistema Nervoso Simpático/fisiopatologia
15.
Acta Radiol ; 47(1): 65-70, 2006 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-16498935

RESUMO

PURPOSE: To study which of the two most used radiopharmaceutical drugs for the sentinel lymph node (SLN) biopsy procedure (dextran 500 99mTc and phytate 99mTc) best defines the SLN and migrates less to other lymph nodes. MATERIAL AND METHODS: Thirty-two rats, separated into two groups, underwent lymphoscintigraphy examination with either dextran or phytate followed by sentinel (popliteal), lumbar, and inguinal lymph node biopsy. Radiation was detected with a gamma probe. RESULTS: The statistical study indicated count rates significantly higher in the SLN than in the other basins for both the dextran (P<0.01) and phytate groups (P<0.001). There was no statistically significant difference concerning SLN absorption in either group (P=0.2981). In the dextran group, migration occurred to 1.5 lymphatic basins with counting higher than 10% of that found in the SLN versus 0.8 in the phytate group (P=0.0023). Migration was thus higher in the dextran group (P=0.0207). CONCLUSION: There was no statistically significant difference between dextran and phytate in the SLN identification, but the phytate migrated to fewer lymphatic basins beyond the SLN and with less intensity.


Assuntos
Dextranos/administração & dosagem , Linfonodos/diagnóstico por imagem , Ácido Fítico/administração & dosagem , Compostos Radiofarmacêuticos/administração & dosagem , Biópsia de Linfonodo Sentinela/métodos , Tecnécio/administração & dosagem , Animais , Dextranos/farmacocinética , Masculino , Ácido Fítico/farmacocinética , Cintilografia , Ratos , Ratos Wistar , Tecnécio/farmacocinética , Distribuição Tecidual/fisiologia
16.
Rev Esp Enferm Dig ; 97(1): 24-37, 2005 Jan.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-15801895

RESUMO

AIM: To evaluate the human and material resources available for sedation, and the usual manner of handling them at endoscopic units in Galicia. METHODS: A prospective and descriptive study based on the performance, distribution, and analysis of a clinical practice inquiry. We requested information about endoscopies performed, available means for sedation, sedation monitoring, and level of sedation used in each procedure. RESULTS: Our inquiry was answered by twenty endoscopic units (thirteen were in public hospitals, and eleven performed complex procedures). Of these units, 80% had a pulse oximeter, 42% had continuous electrocardiography, 40% had a defibrillator, and 45% had a recovery area. The drug most commonly used in gastroscopies was midazolam (76%), and the combination midazolam-meperidine was most frequent in both colonoscopies (72%) and ERCPs (60%). An anesthesiologist was usually available for certain procedures in 15% of units, and as an exception in 65%. Of those inquired, 35% wished to have a full-time anesthesiologist in the unit, 25% wished to have an anesthetist only for certain procedures, and 35% on an exceptional basis. Finally, endoscopists considered that 83% of therapeutical gastroscopies, 87% of therapeutical colonoscopies, 98% of ERCPs, 95% of enteroscopies, and 98% of echoendoscopies deserved sedation. CONCLUSIONS: Although endoscopists consider that endoscopic procedures should benefit from sedation in a high proportion, the available resources to safely monitor patients are inadequate in some units.


Assuntos
Anestesiologia , Sedação Consciente , Endoscopia do Sistema Digestório , Recursos em Saúde , Sedação Consciente/estatística & dados numéricos , Endoscopia do Sistema Digestório/estatística & dados numéricos , Humanos , Espanha , Recursos Humanos
17.
Hum Biol ; 76(3): 469-78, 2004 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-15481679

RESUMO

Among azoospermic and severely oligozoospermic men, 7-15% present microdeletions of a region on the long arm of the Y chromosome that has been called AZF (azoospermia factor). Because these deletions present varying relative frequencies in different populations, we decided to ascertain whether their presence was correlated with specific Y-chromosome haplotypes. For that, we evaluated 51 infertile Israeli men, 9 of whom had microdeletions in AZF. Haplotypes were identified using a hierarchical system with eight biallelic DNA markers. We also checked for the presence of the deletion marker 50f2/C, which was absent in all seven patients with isolated AZFc deletion and also in the one patient with isolated AZFb deletion, suggesting that these microdeletions overlap. As expected, haplogroup J was the most common (47%), followed by equal frequencies of haplogroups Y* (xDE, J, K), P* (xR1a, R1b8), K* (xP), and E. In six patients with AZFc deficiencies of comparable size, three belonged to haplogroup J, two belonged to haplogroup P* (xR1a, R1b8), and one belonged to haplogroup R1a. Also, there were no significant differences in the haplotype frequencies between the groups with and without microdeletions. Thus we did not identify any association of a specific haplogroup with predisposition to de novo deletion of the AZF region in the Israeli population.


Assuntos
Cromossomos Humanos Y/genética , Genética Populacional , Oligospermia/genética , Haplótipos , Humanos , Infertilidade Masculina/genética , Israel , Masculino
18.
Braz J Infect Dis ; 8(3): 263-6, 2004 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-15476060

RESUMO

Cat scratch disease (CSD) is an infectious illness caused by a Gram-negative rod named Bartonella henselae. Typical CSD is characterized by a small skin lesion at the site of a scratch or a bite, followed by regional lymphadenopathy, one to two weeks later. Atypical forms may present as ocular manifestations, neurological manifestations, hepatosplenic involvement and vertebral osteomyelitis. Among neurological complications, encephalopathy is by far the most common. Other neurological manifestations are very rare. We report a case of an 11-year-old boy, with a posterior cervical lymphadenopathy and fever. Cat scratch disease was diagnosed and treated after a positive "Whartin-Starry" stain on lymph node biopsy. Two weeks after treatment, the patient was readmitted presenting an acute episode of left hemiplegia. A brain MRI demonstrated a right subcortical fronto-parietal lesion with no contrast enhancement. Complete recovery was observed after corticosteroid treatment.


Assuntos
Bartonella henselae/isolamento & purificação , Doença da Arranhadura de Gato/complicações , Hemiplegia/etiologia , Doença Aguda , Corticosteroides/uso terapêutico , Animais , Antibacterianos/uso terapêutico , Doença da Arranhadura de Gato/diagnóstico , Doença da Arranhadura de Gato/tratamento farmacológico , Gatos , Criança , Claritromicina/uso terapêutico , Humanos , Masculino
19.
Braz. j. infect. dis ; 8(3): 263-266, Jun. 2004. ilus
Artigo em Inglês | LILACS | ID: lil-384167

RESUMO

Cat scratch disease (CSD) is an infectious illness caused by a Gram-negative rod named Bartonella henselae. Typical CSD is characterized by a small skin lesion at the site of a scratch or a bite, followed by regional lymphadenopathy, one to two weeks later. Atypical forms may present as ocular manifestations, neurological manifestations, hepatosplenic involvement and vertebral osteomyelitis. Among neurological complications, encephalopathy is by far the most common. Other neurological manifestations are very rare. We report a case of an 11-year-old boy, with a posterior cervical lymphadenopathy and fever. Cat scratch disease was diagnosed and treated after a positive Whartin-Starry stain on lymph node biopsy. Two weeks after treatment, the patient was readmitted presenting an acute episode of left hemiplegia. A brain MRI demonstrated a right subcortical fronto-parietal lesion with no contrast enhancement. Complete recovery was observed after corticosteroid treatment.


Assuntos
Humanos , Animais , Masculino , Criança , Gatos , Bartonella henselae , Doença da Arranhadura de Gato , Hemiplegia , Doença Aguda , Corticosteroides , Antibacterianos , Claritromicina
20.
Br J Plast Surg ; 57(3): 252-7, 2004 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-15006527

RESUMO

OBJECTIVES: To evaluate the impact of TRAM flap delayed breast reconstruction on health related quality of life in patients who had undergone mastectomy. METHODS: Twenty-five patients following mastectomy were selected consecutively from the Plastic Surgery/Mastology Units of two university hospitals. All subjects underwent breast reconstruction with the use of pedicled TRAM flap. The patients' health related quality of life was assessed by a validated instrument, the SF-36 Health Survey Questionnaire. This was applied preoperatively and postoperatively at 3, 6 and 12-months follow-up. A group of 20 women with mastectomies who have not undergone breast reconstruction was used as a control. To assess patients' satisfaction with breast reconstruction we used Alderman's modified general satisfaction subscale. RESULTS: There was a progressive improvement in all dimensions of the SF-36, and this was statistically significant for seven of the eight dimensions. The scores were significantly higher on 'role emotional' and 'mental health' at 3 months postoperatively, on 'health perception' and 'role physical' at month 6 and on 'physical function', 'pain', health perception and 'social function' at postoperative month 12. Despite the increase in scores, no significant changes in 'vitality' were found. There was no significant preoperative difference between the control group and studied patients, and the control group's scores were significantly lower in all dimensions when compared to postoperative month 12, except on 'physical function'. The level of patients' satisfaction with the TRAM flap breast reconstruction was high. CONCLUSIONS: The data of this study suggest that delayed breast reconstruction with the use of the pedicled TRAM flap provides an improvement in health related quality of life of patients who have undergone mastectomy.


Assuntos
Neoplasias da Mama/cirurgia , Mamoplastia/métodos , Qualidade de Vida/psicologia , Retalhos Cirúrgicos , Adulto , Neoplasias da Mama/fisiopatologia , Emoções , Feminino , Humanos , Mastectomia , Saúde Mental , Pessoa de Meia-Idade , Dor/fisiopatologia , Satisfação do Paciente , Estudos Prospectivos , Fatores de Tempo , Resultado do Tratamento
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