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1.
Breast Care (Basel) ; 16(5): 452-460, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34720804

RESUMO

Background: The aim of this study was to compare the risk of complications and recurrence between oncoplastic and conventional breast surgery. Methods: This is a retrospective analysis of a consecutive series of 436 patients with stage I-III breast cancer who underwent surgery at the University Hospital of Basel between 2011 and 2018. Results: The nipple/skin-sparing mastectomy (NSM/SSM) group showed significantly more delayed wound healing (32.7 vs. 5.8%, p < 0.001) and skin necrosis (13.9 vs. 1.9%, p = 0.020) compared to conventional mastectomy (CM), which corresponded to significantly higher odds of short-term complications (OR 2.34, 95% CI 1.02-5.35, p = 0.044). The incidence rate of long-term morbidity in oncoplastic breast-conserving surgery (OBCS) was significantly higher compared to conventional breast-conserving surgery (CBCS; 25.5 vs. 11.3 per 100 patient years [PY], p < 0.001), in particular concerning chronic pain (13.3 vs. 6.6, p = 0.011) and lymphedema (4.1 vs. 0.4, p = 0.003). Seroma as a long-term morbidity occurred more often in the CM group compared to the NSM/SSM group (5.8 vs. 0.5 per 100 PY, p = 0.004). Patients received adjuvant treatment earlier after CM compared to NSM/SSM (HR 1.83, 95% CI 1.05-3.19, p = 0.034). There were no significant differences in the incidence of positive margins nor in the odds of recurrence after OBCS versus CBCS and after NSM/SSM versus CM. Conclusions: Even though the present study confirmed expected differences in complications and morbidity, it suggested that oncoplastic surgery is oncologically safe. Patients undergoing NSM/SSM should be followed closely to allow early detection and treatment of frequently associated complications and ensure timely start of adjuvant therapy.

2.
Br J Cancer ; 125(1): 23-27, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33762721

RESUMO

Circulating tumour cell (CTC) clusters have been proposed to be major players in the metastatic spread of breast cancer, particularly during advanced disease stages. Yet, it is unclear whether or not they manifest in early breast cancer, as their occurrence in patients with metastasis-free primary disease has not been thoroughly evaluated. In this study, exploiting nanostructured titanium oxide-coated slides for shear-free CTC identification, we detect clustered CTCs in the curative setting of multiple patients with early breast cancer prior to surgical treatment, highlighting their presence already at early disease stages. These results spotlight an important aspect of metastasis biology and the possibility to intervene with anti-cluster therapeutics already during the early manifestation of breast cancer.

3.
Nat Nanotechnol ; 16(3): 344-353, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33318639

RESUMO

In plants, pathogen attack can induce an immune response known as systemic acquired resistance that protects against a broad spectrum of pathogens. In the search for safer agrochemicals, silica nanoparticles (SiO2 NPs; food additive E551) have recently been proposed as a new tool. However, initial results are controversial, and the molecular mechanisms of SiO2 NP-induced disease resistance are unknown. Here we show that SiO2 NPs, as well as soluble Si(OH)4, can induce systemic acquired resistance in a dose-dependent manner, which involves the defence hormone salicylic acid. Nanoparticle uptake and action occurred exclusively through the stomata (leaf pores facilitating gas exchange) and involved extracellular adsorption in the air spaces in the spongy mesophyll of the leaf. In contrast to the treatment with SiO2 NPs, the induction of systemic acquired resistance by Si(OH)4 was problematic since high Si(OH)4 concentrations caused stress. We conclude that SiO2 NPs have the potential to serve as an inexpensive, highly efficient, safe and sustainable alternative for plant disease protection.


Assuntos
Arabidopsis/efeitos dos fármacos , Resistência à Doença/genética , Nanopartículas/química , Arabidopsis/genética , Arabidopsis/crescimento & desenvolvimento , Doenças das Plantas/genética , Doenças das Plantas/prevenção & controle , Espécies Reativas de Oxigênio/química , Ácido Salicílico/química , Dióxido de Silício/química , Dióxido de Silício/farmacologia
4.
5.
Eur J Cancer Prev ; 29(1): 53-59, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-30998527

RESUMO

One in five women will experience depression over her lifetime, and one out of eight will develop breast cancer. We evaluated the effect of depression on adherence to mammography in Switzerland, where opportunistic and organized screening programs coexist. We analyzed data from 3206 women aged 50-69 who participated in the Swiss Health Survey 2012. We compared mammographic rates among women with no to mild versus moderate to severe depressive symptoms. The effect of the type of screening on the odds of undertaking a mammography was calculated using multivariable logistic regression analysis. Women with moderate to severe major depressive symptoms were more likely to have had a mammography in the previous 2 years than their nondepressed or less-depressed counterparts (51 vs. 39.2%, respectively, P = 0.005). In the multivariable analysis, women with no to mild major depression living in cantons with an organized screening program had an adjusted odds ratio of 2.7 (95% confidence interval: 2.30-3.17, P < 0.001) of having had a mammography within the past 24 months compared with those living in the regions with an opportunistic screening. The adjusted odds ratio for women with moderate to severe major depression was 4.21 (95% confidence interval: 2.13-8.33, P < 0.001). In Switzerland. adherence to mammographic screening among women with moderate to severe major depression is higher than among women with no or minimal major depressive symptoms. This increased adherence is even more pronounced in regions with organized screening.


Assuntos
Neoplasias da Mama/prevenção & controle , Transtorno Depressivo Maior/epidemiologia , Detecção Precoce de Câncer/estatística & dados numéricos , Programas de Rastreamento/estatística & dados numéricos , Cooperação do Paciente/estatística & dados numéricos , Idoso , Neoplasias da Mama/diagnóstico , Estudos Transversais , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/psicologia , Detecção Precoce de Câncer/psicologia , Detecção Precoce de Câncer/normas , Feminino , Inquéritos Epidemiológicos/estatística & dados numéricos , Humanos , Mamografia/psicologia , Mamografia/normas , Mamografia/estatística & dados numéricos , Programas de Rastreamento/organização & administração , Programas de Rastreamento/psicologia , Programas de Rastreamento/normas , Pessoa de Meia-Idade , Cooperação do Paciente/psicologia , Questionário de Saúde do Paciente/estatística & dados numéricos , Guias de Prática Clínica como Assunto , Índice de Gravidade de Doença , Suíça/epidemiologia
6.
Sci Rep ; 9(1): 7938, 2019 05 28.
Artigo em Inglês | MEDLINE | ID: mdl-31138841

RESUMO

As the commercial use of synthetic amorphous silica nanomaterials (SiO2-NPs) increases, their effects on the environment and human health have still not been explored in detail. An often-insurmountable obstacle for SiO2-NP fate and hazard research is the challenging analytics of solid particulate silica species, which involves toxic and corrosive hydrofluoric acid (HF). We therefore developed and validated a set of simple hydrofluoric acid-free sample preparation methods for the quantification of amorphous SiO2 micro- and nanoparticles. To circumvent HF, we dissolved the SiO2-NPs by base-catalyzed hydrolysis at room temperature or under microwave irradiation using potassium hydroxide, replacing the stabilizing fluoride ions with OH-, and exploiting the stability of the orthosilicic acid monomer under a strongly basic pH. Inductively coupled plasma - optical emission spectroscopy (ICP-OES) or a colorimetric assay served to quantify silicon. The lowest KOH: SiO2 molar ratio to effectively dissolve and quantify SiO2-NPs was 1.2 for colloidal Stöber SiO2-NPs at a pH >12. Fumed SiO2-NPs (Aerosil®) or food grade SiO2 (E551) containing SiO2-NPs were degradable at higher KOH: SiO2 ratios >8000. Thus, hydrofluoric acid-free SiO2-NP digestion protocols based on KOH present an effective (recoveries of >84%), less hazardous, and easy to implement alternative to current methods.

7.
PLoS One ; 14(4): e0213834, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30939134

RESUMO

OBJECTIVES: Pelvic congestion syndrome is defined as chronic pelvic pain due to incompetent (dilated and refluxing) pelvic veins. The aim of this study was to investigate the prevalence of this condition by examining the prevalence of dilated ovarian and para-uterine veins in pre- and postmenopausal female patients, irrespective of their symptoms. We subsequently investigated how many women with dilated veins suffered from chronic pelvic pain. Additionally, we attempted to define diagnostic criteria that may allow for early identification of affected patients. METHODS: We reassessed 2384 abdomino-pelvic computed tomography scans performed on women at our institution. The maximal diameters of the ovarian and para-uterine veins were measured. Patients with a pathological process in the abdomen or pelvis affecting the veins were excluded. We considered ovarian vein dilation to be 6 mm or more in the axial plane. For patients that met these criteria, we performed a retrospective chart review to evaluate the clinical presentation and/or symptoms of these patients. RESULTS: Dilated pelvic veins were present in 293/2384 (12%) patients, 118/559 premenopausal (21%) and 175/1825 postmenopausal (10%). Chronic pelvic pain of unclear etiology had been documented prior to the CT in 54/293 (18%) women with dilated veins-2% of the whole study collective (54/2384); 8% of all premenopausal (44/559) and 0.5% of all postmenopausal (10/1825). It was often accompanied by urological symptoms such as hematuria, dysuria, and urinary frequency, in the absence of infection (p<0.05). We identified a strong correlation between the presence of dilated ovarian veins and chronic pelvic pain in premenopausal parous patients with hematuria. CONCLUSIONS: Pelvic congestion syndrome appears to be an underdiagnosed and undertreated disease. In our study, 8% of all premenopausal women had documented chronic pelvic pain of unclear etiology and dilated ovarian and pelvic veins on cross-sectional imaging studies. The features we identified in this study as most relevant should enable a faster identification of patients who could benefit from a specific treatment regimen for this condition.


Assuntos
Dor Crônica/etiologia , Ovário/irrigação sanguínea , Dor Pélvica/etiologia , Pelve/irrigação sanguínea , Varizes/diagnóstico , Adulto , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Ovário/diagnóstico por imagem , Pelve/diagnóstico por imagem , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Varizes/complicações , Veias/diagnóstico por imagem
8.
Breast Cancer Res Treat ; 172(3): 523-537, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30182349

RESUMO

PURPOSE: Indications for nipple-sparing mastectomy (NSM) have broadened to include the risk reducing setting and locally advanced tumors, which resulted in a dramatic increase in the use of NSM. The Oncoplastic Breast Consortium consensus conference on NSM and immediate reconstruction was held to address a variety of questions in clinical practice and research based on published evidence and expert panel opinion. METHODS: The panel consisted of 44 breast surgeons from 14 countries across four continents with a background in gynecology, general or reconstructive surgery and a practice dedicated to breast cancer, as well as a patient advocate. Panelists presented evidence summaries relating to each topic for debate during the in-person consensus conference. The iterative process in question development, voting, and wording of the recommendations followed the modified Delphi methodology. RESULTS: Consensus recommendations were reached in 35, majority recommendations in 24, and no recommendations in the remaining 12 questions. The panel acknowledged the need for standardization of various aspects of NSM and immediate reconstruction. It endorsed several oncological contraindications to the preservation of the skin and nipple. Furthermore, it recommended inclusion of patients in prospective registries and routine assessment of patient-reported outcomes. Considerable heterogeneity in breast reconstruction practice became obvious during the conference. CONCLUSIONS: In case of conflicting or missing evidence to guide treatment, the consensus conference revealed substantial disagreement in expert panel opinion, which, among others, supports the need for a randomized trial to evaluate the safest and most efficacious reconstruction techniques.


Assuntos
Neoplasias da Mama/cirurgia , Mamoplastia/métodos , Mastectomia Subcutânea/métodos , Consenso , Feminino , Humanos , Mastectomia Subcutânea/efeitos adversos , Necrose , Mamilos/patologia , Retalhos Cirúrgicos/patologia
10.
Oncotarget ; 8(43): 75617-75626, 2017 Sep 26.
Artigo em Inglês | MEDLINE | ID: mdl-29088896

RESUMO

BACKGROUND: Anthracycline- and taxane-based adjuvant chemotherapies are the most frequently used systemic treatments for women with triple negative breast cancer (TNBC). Adding platinum derivatives in the neo-adjuvant setting has been shown to not only improve the pCR rates, but also the 3 year DFS for TNBC patients; however, data on platinum derivatives in the adjuvant setting are limited. METHODS: We conducted a retrospective, single-center study in a Swiss breast cancer cohort to evaluate the role of carboplatin in addition to standard adjuvant therapy (anthracyclines and/ or taxanes) in early TNBC patients. All patients with stage I-III TNBC who underwent primary breast surgery between 2004 and 2014 were included. RESULTS: Eighty-three patients were included in the analysis. Stage and grade were well balanced between patients treated with standard chemotherapy (N=54; cohort A) or standard chemotherapy plus carboplatin (N=29; cohort B). The median time to local relapse (LRFS) was 15.0 months in cohort A versus 16.0 months in cohort B (p=0.655). The median time to distant relapse (DRFS) was 29.5 months in cohort A versus 25.0 months in cohort B (p=0.606) There was also no difference in overall survival between the two cohorts (mean overall survival 98 and 91 months, respectively; p=0.208). DISCUSSION: Our data suggest that in an unselected cohort of early TNBC patients, the addition of carboplatin in the adjuvant setting may not be beneficial with respect to relapse-free and overall survival. Further prospective trials to evaluate the addition of platinum in the adjuvant setting are warranted, especially to define subgroups of TNBC patients, which might benefit from carboplatin therapy.

11.
Case Rep Oncol ; 10(3): 876-884, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29118704

RESUMO

Background: The clinical presentation of Langerhans cell histiocytosis (LCH) is heterogeneous ranging from single-organ involvement to systemic disease causing substantial morbidity and mortality. We describe an unusual course of severe multisystem LCH with spontaneous remission. Case Presentation: We report on a 45-year-old Caucasian woman with cervical cancer, FIGO stage IVB. Five months after the end of combined radiochemotherapy and brachytherapy, the patient was readmitted because of severe dysuria. Sterile leukocyturia was seen, and cystoscopy revealed only 3 unspecific small mucosal lesions compatible with postradiation cystitis. Incidentally, a computed tomography (CT) scan of the body showed diffuse micronodular and cystic lesions in lungs and hypodense lesions in the liver. Biopsies revealed infiltrations of CD1a and Langerin (CD207)-positive histiocytes in the lung, liver, and bladder. Additionally, positron emission tomography-CT (PET-CT) was compatible with bone involvement. Retrospective analysis revealed that the increase in alkaline phosphatase might have been a surrogate of bone marrow infiltration with osseous activity. Repeated pneumothoraces occurred, and only one course of vinblastine-prednisolone could be applied. Despite ongoing tobacco consumption and without further therapy, PET-CT showed considerable remission 2 months later. However, despite stable remission, documented by serial PET and conventional CT scans, persistent infiltration of the bladder by Langerhans histiocytes could still be demonstrated 17 months later. Unfortunately, cervical cancer recurred and progressed. Conclusion: Multisystem LCH may rapidly occur, may be oligosymptomatic and, even in high-risk cases, remission without specific therapy might occur. Whether alkaline phosphatase might be a surrogate to monitor osseous disease activity has to be further explored.

12.
Environ Sci Technol ; 51(15): 8682-8691, 2017 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-28686423

RESUMO

Terrestrial plants can internalize and translocate nanoparticles (NPs). However, direct evidence for the processes driving the NP uptake and distribution in plants is scarce at the cellular level. Here, NP-root interactions were investigated after 10 days of exposure of Arabidopsis thaliana to 10 mg·L-1 of negatively or positively charged gold NPs (∼12 nm) in gels. Two complementary imaging tools were used: X-ray computed nanotomography (nano-CT) and enhanced dark-field microscopy combined with hyperspectral imaging (DF-HSI). The use of these emerging techniques improved our ability to detect and visualize NP in plant tissue: by spectral confirmation via DF-HSI, and in three dimensions via nano-CT. The resulting imaging provides direct evidence that detaching border-like cells (i.e., sheets of border cells detaching from the root) and associated mucilage can accumulate and trap NPs irrespective of particle charge. On the contrary, border cells on the root cap behaved in a charge-specific fashion: positively charged NPs induced a higher mucilage production and adsorbed to it, which prevented translocation into the root tissue. Negatively charged NPs did not adsorb to the mucilage and were able to translocate into the apoplast. These observations provide direct mechanistic insight into NP-plant interactions, and reveal the important function of border cells and mucilage in interactions of plants with charged NPs.


Assuntos
Arabidopsis/química , Ouro , Nanopartículas , Raízes de Plantas , Raios X
13.
Breast ; 34 Suppl 1: S78-S81, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28690106

RESUMO

Oncoplastic breast conserving surgery is increasingly used to treat patients with breast cancer. In the absence of randomized data, a large body of observational evidence consistently indicates low rates of recurrence and high rates of survival, but points to a higher rate of complications compared to conventional breast conserving surgery. Established goals of oncoplastic breast conserving surgery are to broaden the indication for breast conservation towards larger tumors, and to improve esthetic outcomes. The benefit from the patient's perspective, however, remains largely to be confirmed. There is a growing demand to standardize various aspects of oncoplastic breast conserving surgery for implementation in clinical research and practice. Several classification systems and outcomes measurement tools have been proposed, but to the present day, none of them has achieved international acceptance.


Assuntos
Neoplasias da Mama/cirurgia , Mamoplastia/métodos , Mastectomia Segmentar/métodos , Feminino , Humanos , Mamoplastia/normas , Mastectomia Segmentar/efeitos adversos , Mastectomia Segmentar/normas , Avaliação de Resultados da Assistência ao Paciente , Resultado do Tratamento
14.
Breast Cancer Res Treat ; 165(1): 139-149, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28578506

RESUMO

PURPOSE: To obtain consensus recommendations for the standardization of oncoplastic breast conserving surgery (OPS) from an international panel of experts in breast surgery including delegates from the German, Austrian and Swiss societies of senology. METHODS: A total of 52 questions were addressed by electronic voting. The panel's recommendations were put into context with current evidence and the report was circled in an iterative open email process until consensus was obtained. RESULTS: The panelists considered OPS safe and effective for improving aesthetic outcomes and broadening the indication for breast conserving surgery (BCS) towards larger tumors. A slim majority believed that OPS reduces the rate of positive margins; however, there was consensus that OPS is associated with an increased risk of complications compared to conventional BCS. The panel strongly endorsed patient-reported outcomes measurement, and recommended selected scales of the Breast-Q™-Breast Conserving Therapy Module for that purpose. The Clough bi-level classification was recommended for standard use in clinical practice for indicating, planning and performing OPS, and the Hoffmann classification for surgical reports and billing purposes. Mastopexy and reduction mammoplasty were the only two recognized OPS procedure categories supported by a majority of the panel. Finally, the experts unanimously supported the statement that every OPS procedure should be tailored to each individual patient. CONCLUSIONS: When implemented into clinical practice, the panel recommendations may improve safety and effectiveness of OPS. The attendees agreed that there is a need for prospective multicenter studies to optimize patient selection and for standardized criteria to qualify and accredit OPS training centers.


Assuntos
Neoplasias da Mama/cirurgia , Medicina Baseada em Evidências/normas , Mastectomia Segmentar/normas , Neoplasias da Mama/patologia , Consenso , Feminino , Humanos , Cooperação Internacional , Mastectomia Segmentar/efeitos adversos , Mastectomia Segmentar/métodos , Resultado do Tratamento
15.
Environ Sci Technol ; 51(9): 4936-4943, 2017 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-28383882

RESUMO

Aquatic ecosystems are expected to receive Ag0 and Ag2S nanoparticles (NPs) through anthropogenic waste streams. The speciation of silver in Ag-NPs affects their fate in ecosystems, but its influence on interactions with aquatic plants is still unclear. Here, the Ag speciation and distribution was measured in an aquatic plant, duckweed (Landoltia punctata), exposed to Ag0 or Ag2S NPs, or to AgNO3. The silver distribution in duckweed roots was visualized using synchrotron-based micro X-ray fluorescence (XRF) mapping and Ag speciation was determined using extended X-ray absorption fine structure (EXAFS) spectroscopy. Duckweed exposed to Ag2S-NPs or Ag0-NPs accumulated similar Ag concentrations despite an order of magnitude smaller dissolved Ag fraction measured in the exposure medium for Ag2S-NPs compared to Ag0-NPs. By 24 h after exposure, all three forms of silver had accumulated on and partially in the roots regardless of the form of Ag exposed to the plants. Once associated with duckweed tissue, Ag0-NPs had transformed primarily into silver sulfide and silver thiol species. This suggests that plant defenses were active within or at the root surface. The Ag2S-NPs remained as Ag2S, while AgNO3 exposure led to Ag0 and sulfur-associated Ag species in plant tissue. Thus, regardless of initial speciation, Ag was readily available to duckweed.


Assuntos
Nanopartículas Metálicas/química , Prata/química , Araceae , Raízes de Plantas
16.
Gynecol Obstet Invest ; 82(2): 119-124, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-27078033

RESUMO

BACKGROUND: The study aimed to improve breast cancer diagnosis with new ultrasound (US) modalities. We examined whether real-time elastography (RTE) complements the diagnostic performance of US. METHODS: The Ethical Committee approved the study. Patients provided written informed consent and received a whole breast workup. Breast lesions were evaluated by US and RTE. Lesions were assessed by BI-RADS, Tsukuba score (TS) and strain ratio (SR). RESULTS: The study included 164 breast lesions of which 101 were benign and 63 malignant. Women with benign lesions were predominantly premenopausal with sonographic dense breast tissue. Women with breast cancer were mostly postmenopausal, with a low sonographic density. Benign lesions had a mean TS of 2.05, which was significantly lower than the mean TS of 3.25 for malignant lesions. The SR for benign lesions (SR 1.83) was significantly smaller than for breast cancer (SR 4.83). Sensitivity and specificity was 95 and 81% for BI-RADS, 39 and 94% for TS, and 57 and 83% for SR, with a cutoff at 2.5. The combination of BI-RADS, TS and SR yielded a sensitivity of 95% and a specificity of 85%. CONCLUSION: Besides morphologic features revealed by US, elastic properties of breast lesions obtained by RTE can be exploited for diagnostic breast imaging.


Assuntos
Doenças Mamárias/diagnóstico por imagem , Neoplasias da Mama/diagnóstico por imagem , Técnicas de Imagem por Elasticidade/normas , Ultrassonografia Mamária/normas , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Pessoa de Meia-Idade , Sensibilidade e Especificidade , Adulto Jovem
17.
Ultrasound Med Biol ; 42(11): 2622-2629, 2016 11.
Artigo em Inglês | MEDLINE | ID: mdl-27503826

RESUMO

Our aim was to prospectively evaluate inter- and intra-observer agreement between Breast Imaging Reporting and Data System (BI-RADS) classifications and Tsukuba elasticity scores (TSs) of breast lesions. The study included 164 breast lesions (63 malignant, 101 benign). The BI-RADS classification and TS of each breast lesion was assessed by the examiner and twice by three reviewers at an interval of 2 months. Weighted κ values for inter-observer agreement ranged from moderate to substantial for BI-RADS classification (κ = 0.585-0.738) and was substantial for TS (κ = 0.608-0.779). Intra-observer agreement was almost perfect for ultrasound (US) BI-RADS (κ = 0.847-0.872) and TS (κ = 0.879-0.914). Overall, individual reviewers are highly self-consistent (almost perfect intra-observer agreement) with respect to BI-RADS classification and TS, whereas inter-observer agreement was moderate to substantial. Comprehensive training is essential for achieving high agreement and minimizing the impact of subjectivity. Our results indicate that breast US and real-time elastography can achieve high diagnostic performance.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Técnicas de Imagem por Elasticidade/métodos , Sistemas de Informação em Radiologia/estatística & dados numéricos , Ultrassonografia Mamária/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Mama/diagnóstico por imagem , Elasticidade , Feminino , Humanos , Pessoa de Meia-Idade , Variações Dependentes do Observador , Estudos Prospectivos , Reprodutibilidade dos Testes , Adulto Jovem
18.
J Perinat Med ; 44(5): 511-5, 2016 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-25980381

RESUMO

OBJECTIVE: To assess the risk for preterm deliveries <37 week of gestation and associated prevalence of vaginal infection in a rural setting after the tsunami in Banda Aceh, Indonesia. METHODS: Wet mount microscopy, vaginal pH and vaginal swabs for microbiological culture were collected in pregnant women during the 2nd trimester from February to June of 2005 in four temporary outpatient clinics and the patients were followed up until delivery. RESULTS: One hundred and fifty-nine pregnant patients were screened. Sixty-two could be followed up until delivery. Thirty-nine (62.9%) delivered at term and 23 (37.1%) delivered prematurely. Significant risk factors for preterm delivery were a history of preterm delivery and group B streptococcus infection. Increased vaginal pH alone had no significant influence on preterm delivery, although there was a trend. CONCLUSION: The rate of preterm delivery was high in this cohort. We suggest risk stratification for preterm delivery in rural conditions by performing a vaginal pH and wet mount microscopy. If either is suspect we suggest collecting a vaginal swab for microbiological culture for targeted treatment. Patients with a history of preterm delivery are at increased risk and should be monitored closely.


Assuntos
Nascimento Prematuro/epidemiologia , Adulto , Estudos de Coortes , Feminino , Humanos , Indonésia/epidemiologia , Recém-Nascido , Recém-Nascido Prematuro , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Prevalência , Fatores de Risco , Saúde da População Rural , Tsunamis , Doenças Vaginais/complicações , Doenças Vaginais/epidemiologia
19.
Nanotoxicology ; 10(3): 257-78, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26067571

RESUMO

Uptake, transport and toxicity of engineered nanomaterials (ENMs) into plant cells are complex processes that are currently still not well understood. Parts of this problem are the multifaceted plant anatomy, and analytical challenges to visualize and quantify ENMs in plants. We critically reviewed the currently known ENM uptake, translocation, and accumulation processes in plants. A vast number of studies showed uptake, clogging, or translocation in the apoplast of plants, most notably of nanoparticles with diameters much larger than the commonly assumed size exclusion limit of the cell walls of ∼5-20 nm. Plants that tended to translocate less ENMs were those with low transpiration, drought-tolerance, tough cell wall architecture, and tall growth. In the absence of toxicity, accumulation was often linearly proportional to exposure concentration. Further important factors strongly affecting ENM internalization are the cell wall composition, mucilage, symbiotic microorganisms (mycorrhiza), the absence of a cuticle (submerged plants) and stomata aperture. Mostly unexplored are the roles of root hairs, leaf repellency, pit membrane porosity, xylem segmentation, wounding, lateral roots, nodes, the Casparian band, hydathodes, lenticels and trichomes. The next steps towards a realistic risk assessment of nanoparticles in plants are to measure ENM uptake rates, the size exclusion limit of the apoplast and to unravel plant physiological features favoring uptake.


Assuntos
Nanopartículas/metabolismo , Plantas/metabolismo , Transporte Biológico , Modelos Biológicos
20.
Environ Sci Technol ; 49(14): 8451-60, 2015 Jul 21.
Artigo em Inglês | MEDLINE | ID: mdl-26106801

RESUMO

Terrestrial crops are directly exposed to silver nanoparticles (Ag-NPs) and their environmentally transformed analog silver sulfide nanoparticles (Ag2S-NPs) when wastewater treatment biosolids are applied as fertilizer to agricultural soils. This leads to a need to understand their bioavailability to plants. In the present study, the mechanisms of uptake and distribution of silver in alfalfa (Medicago sativa) were quantified and visualized upon hydroponic exposure to Ag-NPs, Ag2S-NPs, and AgNO3 at 3 mg total Ag/L. Total silver uptake was measured in dried roots and shoots, and the spatial distribution of elements was investigated using transmission electron microscopy (TEM) and synchrotron-based X-ray imaging techniques. Despite large differences in release of Ag(+) ions from the particles, Ag-NPs, Ag2S-NPs, and Ag(+) became associated with plant roots to a similar degree, and exhibited similarly limited (<1%) amounts of translocation of silver into the shoot system. X-ray fluorescence (XRF) mapping revealed differences in the distribution of Ag into roots for each treatment. Silver nanoparticles mainly accumulated in the (columella) border cells and elongation zone, whereas Ag(+) accumulated more uniformly throughout the root. In contrast, Ag2S-NPs remained largely adhered to the root exterior, and the presence of cytoplasmic nano-SixOy aggregates was observed. Exclusively in roots exposed to particulate silver, NPs smaller than the originally dosed NPs were identified by TEM in the cell walls. The apparent accumulation of Ag in the root apoplast determined by XRF, and the presence of small NPs in root cell walls suggests uptake of partially dissolved NPs and translocation along the apoplast.


Assuntos
Poluentes Ambientais/farmacocinética , Medicago sativa/efeitos dos fármacos , Nanopartículas Metálicas , Compostos de Prata/farmacocinética , Prata/farmacocinética , Disponibilidade Biológica , Transporte Biológico , Citoplasma/efeitos dos fármacos , Citoplasma/metabolismo , Medicago sativa/metabolismo , Nanopartículas Metálicas/química , Microscopia Eletrônica de Transmissão , Raízes de Plantas/química , Raízes de Plantas/efeitos dos fármacos , Raízes de Plantas/metabolismo , Prata/análise , Solo , Espectrometria por Raios X , Águas Residuárias/química
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