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1.
J Chem Phys ; 155(9): 094105, 2021 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-34496590

RESUMO

We present a new geodesic-based method for geometry optimization in a basis set of redundant internal coordinates. Our method updates the molecular geometry by following the geodesic generated by a displacement vector on the internal coordinate manifold, which dramatically reduces the number of steps required to converge to a minimum. Our method can be implemented in any existing optimization code, requiring only implementation of derivatives of the Wilson B-matrix and the ability to numerically solve an ordinary differential equation.

2.
Facts Views Vis Obgyn ; 13(1): 3-7, 2021 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-33889855

RESUMO

The preoperative work-up and optimal surgical approach to colorectal endometriosis is a highly studied topic lacking definitive recommendations. Synthesis of the available data can be extremely challenging for surgeons due to the heterogeneity of existing comparisons, a variety of studied surgical outcomes, and a predominant focus on operative complications. While these considerations are extremely important for surgeons performing such complex gynaecologic surgery there is still much to be desired with regards to evidence based guidelines for the preoperative assessment and surgical technique for colorectal endometriosis. Having an established guideline stating in which clinical situations endometriosis surgeons should performing rectovaginal shaving, versus discoid excision, versus segmental resection would be extremely important for all pelvic surgeons, even those operating in high-volume centres dedicated to the surgical management of complex endometriosis. This perspective highlights the shortcomings of the available data and attempts to create an algorithm surgeons can follow when performing surgery for colorectal endometriosis. This algorithm is based on our expert opinion after synthesising available data.

3.
PLoS Med ; 18(2): e1003273, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33566817

RESUMO

BACKGROUND: Sexual transmission chains of Ebola virus (EBOV) have been verified and linked to EBOV RNA persistence in semen, post-recovery. The rate of semen persistence over time, including the average duration of persistence among Ebola virus disease (EVD) survivors, is not well known. This cohort study aimed to analyze population estimates of EBOV RNA persistence rates in semen over time, and associated risk factors in a population of survivors from Sierra Leone. METHODS AND FINDINGS: In this cohort study from May 2015 to April 2017 in Sierra Leone, recruitment was conducted in 2 phases; the first enrolled 100 male participants from the Western Area District in the capital of Freetown, and the second enrolled 120 men from the Western Area District and from Lungi, Port Loko District. Mean age of participants was 31 years. The men provided semen for testing, analyzed by quantitative reverse transcription PCR (qRT-PCR) for the presence of EBOV RNA. Follow-up occurred every 2 weeks until the endpoint, defined as 2 consecutive negative qRT-PCR results of semen specimen testing for EBOV RNA. Participants were matched with the Sierra Leone EVD case database to retrieve cycle threshold (Ct) values from the qRT-PCR analysis done in blood during acute disease. A purposive sampling strategy was used, and the included sample composition was compared to the national EVD survivor database to understand deviations from the general male survivor population. At 180 days (6 months) after Ebola treatment unit (ETU) discharge, the EBOV RNA semen positive rate was 75.4% (95% CI 66.9%-82.0%). The median persistence duration was 204 days, with 50% of men having cleared their semen of EBOV RNA after this time. At 270 days, persistence was 26.8% (95% CI 20.0%-34.2%), and at 360 days, 6.0% (95% CI 3.1%-10.2%). Longer persistence was significantly associated with severe acute disease, with probability of persistence in this population at 1 year at 10.1% (95% CI 4.6%-19.8%) compared to the probability approaching 0% for those with mild acute disease. Age showed a dose-response pattern, where the youngest men (≤25 years) were 3.17 (95% CI 1.60, 6.29) times more likely to be EBOV RNA negative in semen, and men aged 26-35 years were 1.85 (95% CI 1.04, 3.28) times more likely to be negative, than men aged >35 years. Among participants with both severe acute EVD and a higher age (>35 years), persistence remained above 20% (95% CI 6.0%-50.6%) at 1 year. Uptake of safe sex recommendations 3 months after ETU discharge was low among a third of survivors. The sample was largely representative of male survivors in Sierra Leone. A limitation of this study is the lack of knowledge about infectiousness. CONCLUSIONS: In this study we observed that EBOV RNA persistence in semen was a frequent phenomenon, with high population rates over time. This finding will inform forthcoming updated recommendations on risk reduction strategies relating to sexual transmission of EBOV. Our findings support implementation of a semen testing program as part of epidemic preparedness and response. Further, the results will enable planning of the magnitude of testing and targeted counseling needs over time.


Assuntos
Ebolavirus/genética , Doença pelo Vírus Ebola/epidemiologia , RNA Viral/genética , Sêmen/virologia , Adulto , Idoso , Estudos de Coortes , Ebolavirus/patogenicidade , Doença pelo Vírus Ebola/virologia , Humanos , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase em Tempo Real , Fatores de Risco , Sobreviventes/estatística & dados numéricos
4.
Braz. j. biol ; 81(1): 83-91, Feb. 2021. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1153327

RESUMO

Abstract Current study assessed the impact of Lantana camara invasion on native plant diversity in Pothohar region of Pakistan. The approach used for study was random samplings and comparisons of diversity indices [number of species (S), abundance (N), species richness (R), evenness (Jꞌ), Shannon diversity index (Hꞌ) and Simpson index of dominance (λ)] with two categorical factors i.e., invaded and non-invaded (control). Control plots harboured by an average of 1.74 more species/10m2. The control category was diverse (Hꞌ=2.56) than invaded category (Hꞌ=1.56). The higher value of species richness in control plots shows heterogeneous nature of communities and vice versa in invaded plots. At multivariate scale, ordination (nMDS) and ANOSIM showed significant magnitude of differences between invaded and control plots at all sites. The decrease in studied diversity indices in invaded over control sites indicated that plant communities become less productive due to Lantana invasion.


Resumo O presente estudo avaliou o impacto da invasão de Lantana camara na diversidade de plantas nativas na região de Pothohar, no Paquistão. A abordagem utilizada para o estudo foram a amostragem aleatória e a comparação de índices de diversidade, como número de espécies (S), abundância (N), riqueza de espécies (R), equitabilidade (Jꞌ), índice de diversidade de Shannon (Hꞌ) e índice de dominância de Simpson (λ), com dois fatores categóricos, ou seja, invadidos e não invadidos (controle). As parcelas não invadidas tinham, em média, 1,74 espécie a mais / 10 m2 que parcelas invadidas. A categoria controle foi mais diversa (Hꞌ = 2,56) do que a categoria invadida (Hꞌ = 1,56). O maior valor da riqueza de espécies em parcelas de controle mostra a natureza heterogênea das comunidades, e vice-versa, em parcelas invadidas. Na escala multivariada, ordenação (nMDS) e ANOSIM mostraram magnitude significativa das diferenças entre as parcelas invadidas e controle em todos os locais. A diminuição nos índices de diversidade estudados em locais invadidos por controle indicou que as comunidades de plantas se tornam menos produtivas por causa da invasão de Lantana.

5.
Braz J Biol ; 81(1): 83-91, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-32236291

RESUMO

Current study assessed the impact of Lantana camara invasion on native plant diversity in Pothohar region of Pakistan. The approach used for study was random samplings and comparisons of diversity indices [number of species (S), abundance (N), species richness (R), evenness (Jꞌ), Shannon diversity index (Hꞌ) and Simpson index of dominance (λ)] with two categorical factors i.e., invaded and non-invaded (control). Control plots harboured by an average of 1.74 more species/10m2. The control category was diverse (Hꞌ=2.56) than invaded category (Hꞌ=1.56). The higher value of species richness in control plots shows heterogeneous nature of communities and vice versa in invaded plots. At multivariate scale, ordination (nMDS) and ANOSIM showed significant magnitude of differences between invaded and control plots at all sites. The decrease in studied diversity indices in invaded over control sites indicated that plant communities become less productive due to Lantana invasion.


Assuntos
Lantana , Paquistão , Plantas
6.
Facts Views Vis Obgyn ; 12(3): 163-168, 2020 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-33123691

RESUMO

Background: Laparoscopic skills are unlikely to be achieved exclusively in the operating theatre, so simulation training has become mandatory to acquire specific psychomotor skills to be merged in a more complex procedure. Objective: To compare 3-day vs. 1-day laparoscopic suturing courses and to better address participants' needs according to their level of experience. Methods: Observational cohort study conducted between January 2017 and December 2018 including 107 participants amongst which 61 attended a 3-day and 46 the 1-day suturing course. Results: Data analysis showed no significant difference in the pre-test suturing scores between the two groups. On each course, when comparing the pre- and post-tests results, the participants reached a statistically significant improvement in both precision and knotting score (p< 0.01). However, when comparing the two types of courses, the data showed a better performance in the post-session test for those attending the 3-day course (p<0.05), as well as a higher mean score improvement (4.7 vs. 2.8; p<0.05) and time needed to complete exercises (-270s vs. -150s; p<0.05). Furthermore, grouping the participants according to their experience, the experts achieved a significantly better improvement attending the 3-day course, when compared to the beginners. Conclusions: Both 3 and 1-day course are successful in improving laparoscopic suturing skills regardless of the participant's experience. However experienced participants benefit more from a longer course while the 1-day one should be dedicated to pre-surgical competences acquisition.

7.
J Cancer Res Clin Oncol ; 146(11): 2897-2911, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32748119

RESUMO

Advances in surgery, peri-operative care and systemic chemotherapy have not significantly improved the prognosis of pancreatic cancer for several decades. Early clinical trials of immunotherapy have yielded disappointing results proposing other means by which the tumour microenvironment serves to decrease the immune response. Additionally, the emergence of various subtypes of pancreatic cancer has emerged as a factor for treatment responses with immunogenic subtypes carrying a better prognosis. Herein we discuss the reasons for the poor response to checkpoint inhibitors and outline a rationale why combination treatments are likely to be most effective. We review the therapies which could provide optimal synergistic effects to immunotherapy including chemotherapy, agents targeting the stroma, co-stimulatory molecules, vaccinations and methods of immunogenic tumour priming including radiofrequency ablation. Finally, we discuss reasons why peri-operative and in particular neoadjuvant combination treatments are likely to be most effective and should be considered for early clinical trials.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carcinoma Ductal Pancreático/terapia , Terapia Combinada/métodos , Imunoterapia/métodos , Neoplasias Pancreáticas/terapia , Animais , Humanos
8.
J Chem Theory Comput ; 15(11): 6536-6549, 2019 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-31614079

RESUMO

Identification and refinement of first order saddle point (FOSP) structures on the potential energy surface (PES) of chemical systems is a computational bottleneck in the characterization of reaction pathways. Leading FOSP refinement strategies for modestly sized molecular systems require calculation of the full Hessian matrix, which is not feasible for larger systems such as those encountered in heterogeneous catalysis. For these systems, the standard approach to FOSP refinement involves iterative diagonalization of the Hessian, but this comes at the cost of longer refinement trajectories due to the lack of accurate curvature information. We present a method for incorporating information obtained by an iterative diagonalization algorithm into the construction of an approximate Hessian matrix that accelerates FOSP refinement. We measure the performance of our method with two established FOSP refinement benchmarks and find a 50% reduction on average in the number of gradient evaluations required to converge to a FOSP for one benchmark and a 25% reduction on average for the second benchmark.

9.
J Chem Phys ; 150(19): 194101, 2019 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-31117798

RESUMO

A stable explicit time-scale splitting algorithm for stiff chemical Langevin equations (CLEs) is developed, based on the concept of computational singular perturbation. The drift term of the CLE is projected onto basis vectors that span the fast and slow subdomains. The corresponding fast modes exhaust quickly, in the mean sense, and the system state then evolves, with a mean drift controlled by slow modes, on a random manifold. The drift-driven time evolution of the state due to fast exhausted modes is modeled algebraically as an exponential decay process, while that due to slow drift modes and diffusional processes is integrated explicitly. This allows time integration step sizes much larger than those required by typical explicit numerical methods for stiff stochastic differential equations. The algorithm is motivated and discussed, and extensive numerical experiments are conducted to illustrate its accuracy and stability with a number of model systems.

10.
Eur Rev Med Pharmacol Sci ; 22(10): 2973-2977, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29863239

RESUMO

OBJECTIVE: In polytrauma patients, to limit the pelvic space favouring internal bleeding, the use of pelvic binders is now a standard practice. In case of external pelvic binder placement with anatomic reduction of the symphyseal and sacroiliac joints, delayed diagnosis and missed injuries could occur. The aim of this study is to document the risk of missed diagnosis, as well as to identify a possible algorithm for optimal management of traumatized patients with pelvic binders, in order to reach an early diagnosis of pelvic fractures without additional risks. CASE REPORT: We report three cases of open-book pelvic fractures that were initially missed. The external pelvic binders applied had adequately reduced the fractures. The computed tomography on arrival excluded a diastasis of the symphysis pubis. On removal of the pelvic binder and repetition of the radiological imaging, the fractures were evidenced. CONCLUSIONS: We have accordingly created an algorithm for polytrauma patients to determine when the pelvic binder should be released before radiological imaging and when repeated radiological imaging should be done. The use of this algorithm in trauma centers will help to reduce the number of missed injuries, and the number of late diagnoses as well as will increase the patient survival rates.


Assuntos
Algoritmos , Diagnóstico Tardio/prevenção & controle , Fixação de Fratura/métodos , Fraturas Ósseas/diagnóstico por imagem , Traumatismo Múltiplo , Ossos Pélvicos/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ossos Pélvicos/lesões , Reprodutibilidade dos Testes , Tomografia Computadorizada por Raios X/métodos
11.
J Cancer ; 9(4): 629-637, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29556320

RESUMO

Background: Malignant biliary and/or pancreatic obstruction has often encountered in the advanced stages of periampullary and cholangicarcinomas. HabibTM Radiofrequency (RF) ablation has been successfully used in the management of various cancers of liver and pancreas. Percutaneous HPB probe (EMcision Ltd, London, UK) is a new addition to this class of tools. It is an endoluminal Radiofrequency (RF) catheter which works on the principle of ablation and induces coagulative necrosis to recanalize the obstructed duct. The aim of this study is to address the technical details of canalization, feasibilities and outcomes of percutaneous endo-luminal Radiofrequency (RF) catheter in patients with unresectable malignancy with obstructed bile and pancreatic duct (PD). Material and Method: A total of 134 patients with inoperable malignant obstruction of biliary and PD underwent RF based percutaneous endoluminal RF ablation in a tertiary referral centre between December 15th, 2010 to August 7th, 2015. This device was used in a sequential manner with an intent to recanalize the obstructed. Following the initial catheter drainage of the duct, subsequent percutaneous endobiliary RF ablation, the metallic stent was placed to recanalize the obstructed bile and PD secondary to unresectable malignancy under real-time fluoroscopic guidance. Results: The percutaneous RF based ablation of obstructed bile duct and PD with metallic stent placement was successfully achieved in 130 (97.01%) cases. The three failures were noted in cases of biliary obstruction whilst, one with PD obstruction. The patency restored in 124 and patients, where the procedure was successfully completed and revealed clinical improvement reported. Conclusion: The percutaneous endoluminal RF based ablation of obstructed duct with metallic stent placement appeared to be a safe, effective procedure and may improve survival in patients with advanced stage cancer presenting with biliary and PD obstruction. Considering the above mentioned evidence, this modality may stand ahead of stenting alone. This could be considered as viable modality in management of such patients where very limited treatment options are available.

12.
J Healthc Eng ; 2017: 4574172, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29065604

RESUMO

INTRODUCTION: The development augmented reality devices allow physicians to incorporate data visualization into diagnostic and treatment procedures to improve work efficiency, safety, and cost and to enhance surgical training. However, the awareness of possibilities of augmented reality is generally low. This review evaluates whether augmented reality can presently improve the results of surgical procedures. METHODS: We performed a review of available literature dating from 2010 to November 2016 by searching PubMed and Scopus using the terms "augmented reality" and "surgery." Results. The initial search yielded 808 studies. After removing duplicates and including only journal articles, a total of 417 studies were identified. By reading of abstracts, 91 relevant studies were chosen to be included. 11 references were gathered by cross-referencing. A total of 102 studies were included in this review. CONCLUSIONS: The present literature suggest an increasing interest of surgeons regarding employing augmented reality into surgery leading to improved safety and efficacy of surgical procedures. Many studies showed that the performance of newly devised augmented reality systems is comparable to traditional techniques. However, several problems need to be addressed before augmented reality is implemented into the routine practice.


Assuntos
Competência Clínica , Treinamento com Simulação de Alta Fidelidade , Laparoscopia/educação , Cirurgia Assistida por Computador/educação , Realidade Virtual , Humanos , Imageamento Tridimensional
13.
Cardiovasc Intervent Radiol ; 40(12): 1911-1920, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28681224

RESUMO

PURPOSE: The aim of this study is to provide a technical detail and feasibility of percutaneous image-guided pancreatic duct (PD) drainage and to discuss its subtleties in a series of patients with obstructed PD. MATERIALS AND METHODS: Thirty patients presenting with PD obstruction from pancreatic head tumour or pancreatitis were subjected to percutaneous image-guided PD drainage under a guidance of ultrasound or computed tomography. Following the successful puncture of PD, a locking loop drainage catheter was placed using conventional guidewire techniques under real-time fluoroscopy guidance. RESULTS: The percutaneous drainage of obstructed PD was completed in 29 (96.7%) patients as an independent therapeutic intent or as a bridge to further percutaneous procedures. Clinical improvement following drainage was documented by the gradual reduction in clinical symptoms, including pain, nausea and fever and improved blood test results, showing the significant decrease of amylase concentration. The amount of pancreatic fluid drained post procedure was between 300 and 900 mL/day. No major procedure-related complications were observed. Subsequently, 14 of 29 patients underwent further procedures, including endoluminal placement of metal stent with or without radiofrequency ablation, balloon assisted percutaneous descending litholapaxy (BAPDL), endoluminal biopsy and balloon dilatation using the same drainage tract. CONCLUSION: The percutaneous PD drainage appears to be a safe and effective procedure. It should be considered in patients with obstructed PD secondary to malignancy, pancreatitis etc., where endoscopic retrograde cannulation has been failed or impracticable. The procedure can also be contemplated either as an independent treatment option or as an initial step for the subsequent therapeutic endoluminal procedures.


Assuntos
Drenagem/métodos , Pancreatopatias/diagnóstico por imagem , Pancreatopatias/terapia , Ductos Pancreáticos/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Ultrassonografia de Intervenção/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Pancreáticas , Estudos Prospectivos , Radiografia Intervencionista/métodos , Resultado do Tratamento
14.
Oncogene ; 36(36): 5189-5198, 2017 09 07.
Artigo em Inglês | MEDLINE | ID: mdl-28481870

RESUMO

TGF-ß is a multifunctional cytokine affecting many cell types and implicated in tissue remodeling processes. Due to its many functions and cell-specific effects, the consequences of TGF-ß signaling are process-and stage-dependent, and it is not uncommon that TGF-ß exerts distinct and sometimes opposing effects on a disease progression depending on the stage and on the pathological changes associated with the stage. The mechanisms underlying cell- and process-specific effects of TGF-ß are poorly understood. We are describing a novel pathway that mediates induction of angiogenesis in response to TGF-ß1. We found that in endothelial cells (EC) thrombospondin-4 (TSP-4), a secreted extracellular matrix (ECM) protein, is upregulated in response to TGF-ß1 and mediates the effects of TGF-ß1 on angiogenesis. Upregulation of TSP-4 does not require the synthesis of new protein, is not caused by decreased secretion of TSP-4, and is mediated by activation of SMAD3. Using Thbs4-/- mice and TSP-4 shRNA, we found that TSP-4 mediated pro-angiogenic functions in cultured EC and angiogenesis in vivo in response to TGF-ß1. We observed~3-fold increases in tumor mass and levels of angiogenesis markers in animals injected with TGF-ß1, and these effects did not occur in Thbs4-/- animals. Injections of an inhibitor of TGF-ß1 signaling SB-431542 also decreased the weights of tumors and cancer angiogenesis. Our results from in vivo angiogenesis models and cultured EC document that TSP-4 mediates upregulation of angiogenesis by TGF-ß1. Upregulation of pro-angiogenic TSP-4 and selective effects of TSP-4 on EC may contribute to stimulation of tumor growth by TGF-ß despite the inhibition of cancer cell proliferation.


Assuntos
Indutores da Angiogênese/metabolismo , Endotélio Vascular/patologia , Músculo Liso Vascular/patologia , Neovascularização Patológica/patologia , Trombospondinas/fisiologia , Fator de Crescimento Transformador beta/farmacologia , Animais , Movimento Celular/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Células Cultivadas , Embrião de Galinha , Endotélio Vascular/efeitos dos fármacos , Endotélio Vascular/metabolismo , Feminino , Regulação da Expressão Gênica/efeitos dos fármacos , Humanos , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Músculo Liso Vascular/efeitos dos fármacos , Músculo Liso Vascular/metabolismo , Neovascularização Patológica/tratamento farmacológico , Neovascularização Patológica/metabolismo , Transdução de Sinais/efeitos dos fármacos
15.
Eur Psychiatry ; 42: 1-7, 2017 05.
Artigo em Inglês | MEDLINE | ID: mdl-28199868

RESUMO

BACKGROUND: In recent years the association between sexual dysfunction (SD) and obesity in the general population has drawn major attention. Although sexual dysfunction is common in psychosis, its relationship with weight gain and obesity remains unclear. AIMS: To investigate the association between sexual dysfunction and obesity in a cohort of patients with first episode psychosis. METHOD: Sexual function was assessed in a cohort of patients with first episode psychosis using the Sexual Function Questionnaire (SFQ). Anthropometric measures, including weight, BMI, waist, waist-hip ratio were investigated. Additionally, leptin and testosterone were investigated in male patients. RESULTS: A total of 116 patients (61 males and 55 females) were included. Of these 59% of males and 67.3% of females showed sexual dysfunction (SD) according to the SFQ. In males, higher SFQ scores were significantly correlated with higher BMI (Std. ß=0.36, P=0.01), higher leptin levels (Std. ß=0.34, P=0.02), higher waist-hip ratio (Std. ß=0.32, P=0.04) and lower testosterone levels (Std. ß=-0.44, P=0.002). In contrast, in females, SFQ scores were not associated with any of these factors. CONCLUSIONS: While sexual dysfunction is present in both female and male patients with their first episode of psychosis, only in males is sexual dysfunction associated with increased BMI and waist-hip ratio. The association between SD, BMI, low levels of testosterone and high levels of leptin suggest that policies that lead to healthier diets and more active lifestyles can be beneficial at least, to male patients.


Assuntos
Obesidade Abdominal/complicações , Transtornos Psicóticos/complicações , Disfunções Sexuais Psicogênicas/etiologia , Adulto , Índice de Massa Corporal , Peso Corporal , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Ganho de Peso
16.
Plant Foods Hum Nutr ; 72(2): 156-160, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28161878

RESUMO

During the last few years, numerous attempts were made to identify effective α-glucosidase inhibitors from natural sources in order to develop new alternatives for diabetes management. Smallanthus sonchifolius (yacon) leaves were found to be effective in controlling postprandial hyperglycemia. Enhydrin, a constituent of yacon leaves, was noted for its significant hypoglycemic properties in diabetic rats. These properties were also demonstrated for yacon leaves decoction, which is rich in phenolic compounds such as chlorogenic acid and its derivatives. The purpose of the present study was to evaluate the potential of yacon leaves decoction and the isolated compound enhydrin to inhibit α-glucosidase enzyme, a possible mechanism of the above antihyperglycemic effect. In vitro assays showed that both 10% decoction and enhydrin significantly inhibited the activity of the yeast α-glucosidase enzyme in a dose-dependent manner, IC50 values being 50.40 and 134.17 µg/ml, respectively. In vivo experiments showed a rapid decrease in the hyperglycemic peak after sucrose load (2 g/kg body weight) in normal rats treated with the 10% decoction (140 mg/kg) and enhydrin (0.8 mg/kg). Both treatments caused a significant decrease in blood glucose levels in diabetic rats after sucrose load compared to diabetic control. These results suggest that both products assayed could be effective in the management of postprandial hyperglycemia through inhibition of α-glucosidase in the small intestine.


Assuntos
Asteraceae/química , Diabetes Mellitus Experimental/tratamento farmacológico , Inibidores de Glicosídeo Hidrolases/farmacologia , Hiperglicemia/prevenção & controle , Hipoglicemiantes/farmacologia , Sesquiterpenos/farmacologia , Animais , Ácido Clorogênico/isolamento & purificação , Ácido Clorogênico/farmacologia , Diabetes Mellitus Experimental/induzido quimicamente , Modelos Animais de Doenças , Masculino , Extratos Vegetais/química , Extratos Vegetais/isolamento & purificação , Extratos Vegetais/farmacologia , Folhas de Planta/química , Ratos , Ratos Wistar , Sesquiterpenos/química , Sesquiterpenos/isolamento & purificação , Estreptozocina/efeitos adversos , alfa-Glucosidases/metabolismo
19.
Pract Neurol ; 16(4): 323-5, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-26929441
20.
Br J Surg ; 103(4): 328-36, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26791838

RESUMO

BACKGROUND: Drain amylase content in the days immediately after major pancreatic resection has been investigated previously as a predictor of postoperative pancreatic fistula (POPF). Its accuracy, however, has not been determined conclusively. The purpose of this study was to evaluate the accuracy of drain amylase content on the first day after major pancreatic resection in predicting the occurrence of POPF. METHODS: A literature search of the MEDLINE, Embase and Scopus(®) databases to 13 May 2015 was performed to identify studies evaluating the accuracy of drain amylase values on day 1 after surgery in predicting the occurrence of POPF. The area under the hierarchical summary receiver operating characteristic (ROC) curve (AUChSROC ) was calculated as an index of accuracy, and pooled estimates of accuracy indices (sensitivity and specificity) were calculated at different cut-off levels. Subgroup and meta-regression analyses were performed to test the robustness of the results. RESULTS: Thirteen studies involving 4416 patients were included. The AUChSROC was 0·89 (95 per cent c.i. 0·86 to 0·92) for clinically significant POPF and 0·88 (0·85 to 0·90) for POPF of any grade. Pooled estimates of sensitivity and specificity were calculated for the different cut-offs: 90-100 units/l (0·96 and 0·54 respectively), 350 units/l (0·91 and 0·84) and 5000 units/l (0·59 and 0·91). Accuracy was independent of the type of operation, type of anastomosis performed and octreotide administration. CONCLUSION: Evaluation of drain amylase content on the first day after surgery is highly accurate in predicting POPF following major pancreatic resection. It may allow early drain removal and institution of an enhanced recovery pathway.


Assuntos
Pancreatectomia/efeitos adversos , Fístula Pancreática , alfa-Amilases Pancreáticas/metabolismo , Complicações Pós-Operatórias/diagnóstico , Saúde Global , Humanos , Incidência , Fístula Pancreática/enzimologia , Fístula Pancreática/epidemiologia , Fístula Pancreática/etiologia , Complicações Pós-Operatórias/enzimologia , Valor Preditivo dos Testes
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