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1.
BJOG ; 127(1): 88-97, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31544327

RESUMO

OBJECTIVE: To assess the short-term incidence of serious complications of surgery for urinary incontinence or pelvic organ prolapse. DESIGN: Prospective longitudinal cohort study using a surgical registry. SETTING: Thirteen public hospitals in France. POPULATION: A cohort of 1873 women undergoing surgery between February 2017 and August 2018. METHODS: Preliminary analysis of serious complications after a mean follow-up of 7 months (0-18 months), according to type of surgery. Surgeons reported procedures and complications, which were verified by the hospitals' information systems. MAIN OUTCOME MEASURES: Serious complication requiring discontinuation of the procedure or subsequent surgical intervention, life-threatening complication requiring resuscitation, or death. RESULTS: Fifty-two women (2.8%, 95% CI 2.1-3.6%) experienced a serious complication either during surgery, requiring the discontinuation of the procedure, or during the first months of follow-up, necessitating a subsequent reoperation. One woman also required resuscitation; no women died. Of 811 midurethral slings (MUSs), 11 were removed in part or totally (1.4%, 0.7-2.3%), as were two of 391 transvaginal meshes (0.5%, 0.1-1.6%), and four of 611 laparoscopically placed mesh implants (0.7%, 0.2-1.5%). The incidence of serious complications 6 months after the surgical procedure was estimated to be around 3.5% (2.0-5.0%) after MUS alone, 7.0% (2.8-11.3%) after MUS with prolapse surgery, 1.7% (0.0-3.8%) after vaginal native tissue repair, 2.8% (0.9-4.6%) after transvaginal mesh, and 1.0% (0.1-1.9%) after laparoscopy with mesh. CONCLUSIONS: Early serious complications are relatively rare. Monitoring must be continued and expanded to assess the long-term risk associated with mesh use and to identify its risk factors. TWEETABLE ABSTRACT: Short-term serious complications are rare after surgery for urinary incontinence or pelvic organ prolapse, even with mesh.


Assuntos
Diafragma da Pelve/cirurgia , Prolapso de Órgão Pélvico/cirurgia , Telas Cirúrgicas/efeitos adversos , Adulto , Idoso , Idoso de 80 Anos ou mais , Análise de Variância , Colposcopia/efeitos adversos , Colposcopia/mortalidade , Colposcopia/estatística & dados numéricos , Feminino , França/epidemiologia , Humanos , Incidência , Complicações Intraoperatórias/etiologia , Complicações Intraoperatórias/mortalidade , Pessoa de Meia-Idade , Prolapso de Órgão Pélvico/mortalidade , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/mortalidade , Estudos Prospectivos , Sistema de Registros , Slings Suburetrais/efeitos adversos , Slings Suburetrais/estatística & dados numéricos , Telas Cirúrgicas/estatística & dados numéricos , Centros Cirúrgicos/estatística & dados numéricos , Adulto Jovem
2.
Food Chem ; 307: 125521, 2020 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-31655264

RESUMO

The essential oils and antioxidant activity of four Thymus species were evaluated under five light spectra (namely, red, blue, red-blue, white, and greenhouse condition). The highest essential oil yield (4.17%) was observed under red light in T. migricus, while the lowest (1.05%) was observed in T. carmanicus under greenhouse conditions. Light quality also led to difference in essential oil constituents. The highest thymol (66%) was found in T. migricus exposed to blue light, while the least (1.69%) was observed in T. kotschyanus grown under red-blue light. The LED treatments did not induce any significant effect on carvacrol of Thymus species in comparison to the greenhouse condition. Finally, the analysis of variance indicates that the effect of light varied with the studied species. T. migricus performed the highest antioxidant capacity (IC50 = 176.8 µg/mL) under blue light. Overall, essential oil components as well as antioxidants showed significant responses to light emitting diodes wavelengths.


Assuntos
Antioxidantes/metabolismo , Luz , Timol/metabolismo , Thymus (Planta)/química , Análise de Variância , Antioxidantes/química , Cromatografia Gasosa , Análise por Conglomerados , Efeito Estufa , Óleos Voláteis/química , Análise de Componente Principal , Timol/química , Thymus (Planta)/crescimento & desenvolvimento , Thymus (Planta)/metabolismo
3.
Endocrinol. diabetes nutr. (Ed. impr.) ; 66(10): 611-619, dic. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-184788

RESUMO

Antecedentes: El ejercicio intervalado de alta intensidad (HIIT) ha sido utilizado ampliamente para combatir los factores de riesgo cardiovascular en población adolescente y adulta, existiendo un vacío de su aplicabilidad en población infantil. Objetivos: Determinar los efectos de un HIIT sobre distintos parámetros antropométricos y cardiovasculares de niños con sobrepeso y obesidad de entre 7 y 9 años de edad. Material y métodos: Cuatro grupos fueron formados: 1) grupo control con sobrepeso (GCS, n = 30, IMC = 21,60 ± 3,72 kg/m2); 2) grupo control con obesidad (GCO, n = 34, IMC = 23,92 ± 3,11 kg/m2); 3) grupo intervención con sobrepeso (GIS, n = 69, IMC = 20,01 ± 1,88 kg/m2), y 4) grupo intervención con obesidad (GIO, n = 141, IMC=24,12 ± 2,66 kg/m2). El IMC, grasa corporal (GC), circunferencia de cintura, razón cintura-estatura, presión arterial sistólica y diastólica, y capacidad cardiorrespiratoria (CRF), fueron evaluadas pre- y postintervención. Resultados: Existieron diferencias significativas en las variables IMC (p < 0,001), GC (p < 0,001) y CRF (p < 0,001) en la comparación entre grupos (control vs. intervención) en pre- y postintervención (GCS vs. GIS y GCO vs. GIO). El GIS (IMC; pre = 20,01 ± 1,88 vs. post = 19,00 ± 2,02, p < 0,001) y el GIO (IMC; pre = 24,12 ± 2,66 vs. post = 23,23 ± 3,23, p < 0,001) disminuyeron su IMC. De igual forma, en el GIS (GC; pre = 21,84 ± 4,97 vs. post = 19,55±4,81%, p < 0,001) y en el GIO (GC; pre = 30,26 ± 11,49 vs. post =26,81 ± 6,80%, p < 0,001) la GC disminuyó. Ambos grupos intervenidos mejoraron su CRF (p < 0,001). Existió una disminución significativa de escolares con obesidad (pre = 66,4% vs. post = 49,6%) (p < 0,001). Conclusión: La intervención realizada en el contexto escolar mejora los parámetros antropométricos y cardiovasculares de los escolares, permitiendo además disminuir la proporción de escolares con obesidad


Background: High-intensity interval training (HIIT) has been widely used to fight cardiovascular risk factors in adolescents and adults, but no data are available on its applicability in children. Objectives: To assess the effects of HIIT on different anthropometric and cardiovascular parameters of overweight and obese children aged 7-9 years. Material and methods: Four groups were formed: 1) an overweight control group (OWCG, n = 30, BMI = 21.60 ± 3.72 kg/m2); 2) an obesity control group (OCG, n = 34, BMI = 23.92 ± 3.11 kg/m2); 3) an overweight intervention group (OWIG, n = 69, BMI = 20.01 ± 1.88 kg/m2), and 4) an obesity intervention group (OIG, n = 141, BMI = 24.12 ± 2.66 kg/m2). BMI, body fat (BF), waist circumference, height-waist ratio, systolic and diastolic blood pressure and cardiorespiratory fitness (CRF) were assessed before and after intervention. Results: There were significant differences in BMI (P < .001), BF (P < .001), and CRF (P < .001) between the groups (control vs. intervention) before and after intervention (OWCG vs. OWIG and OCG vs. OIG). BMI decreased in the OWIG (BMI, 20.01 ± 1.88 at baseline vs. 19.00 ± 2.02 after HIIT, P < .001) and OIG (BMI, 24.12 ± 2.66 at baseline vs. 23.23 ± 3.23 after HIIT, P < .001) groups. Similarly, BF decreased in the OWIG (BF, 21.84 ± 4.97 at baseline vs. 19.55 ± 4.81% after HIIT, P < .001) and OIG (BF, 30.26 ± 11.49 at baseline vs. 26.81 ± 6.80% after HIIT, P < .001) groups. CRF improved in both intervention groups (P < .001). There was a significant decrease in the prevalence rate of schoolchildren with obesity (from 66.4% to 49.6%) (P < .001). Conclusion: The intervention conducted in the school setting improved the anthropometric and cardiovascular parameters of schoolchildren, and also allowed for reducing the proportion of schoolchildren with obesity


Assuntos
Humanos , Criança , Obesidade Pediátrica/diagnóstico , Obesidade Pediátrica/terapia , Exercício/fisiologia , Aptidão Cardiorrespiratória/fisiologia , Antropometria , Sobrepeso/complicações , Índice de Massa Corporal , Análise de Variância
4.
Braz J Cardiovasc Surg ; 34(5): 572-580, 2019 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-31719008

RESUMO

OBJECTIVE: To characterize the behavior of cardiac autonomic modulation in individuals with different times after orthotopic heart transplantation (HTx) using symbolic dynamics analysis. METHODS: Sixty patients were evaluated after HTx. We recorded their instantaneous R-R intervals (RRi) by cardiac monitor Polar® RS800CX™ (Polar Electro Oy, Kempele, Finland) for 10 minutes. The same sequence of RRi with 256 consecutive beats was used to perform spectral analysis and symbolic dynamics analysis. We used hierarchical clustering to form groups. One-way analysis of variance (ANOVA) (with Holm-Sidak method) or one-way Kruskal-Wallis test (with Dunn´s post-hoc test) was used to analyze the difference between groups. Linear correlation analysis between variables was performed using Pearson's or Spearman's tests. P-value < 0.05 was considered statistically significant. RESULTS: The 0V% index increased, the 2UV% index and the normalized complexity index decreased with an increase of HTx postoperative time. There were a negative correlation between complexity indexes and 0V% and a positive correlation between complexity indexes and 2UV%. CONCLUSION: Symbolic dynamics indexes were able to show a specific cardiac autonomic modulation pattern for HTx recipients with different postoperative times.


Assuntos
Transplante de Coração/reabilitação , Coração/fisiopatologia , Dinâmica não Linear , Sistema Nervoso Parassimpático/fisiopatologia , Sistema Nervoso Simpático/fisiopatologia , Adulto , Análise de Variância , Estudos Transversais , Entropia , Feminino , Frequência Cardíaca/fisiologia , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Valores de Referência , Estudos Retrospectivos , Estatísticas não Paramétricas , Fatores de Tempo
5.
Anticancer Res ; 39(11): 6209-6216, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31704849

RESUMO

BACKGROUND: The appropriate extent of lymphadenectomy on gastric cancer patients with positive peritoneal cytology (CY1) is uncertain. This study retrospectively compared overall survival (OS) after standard and limited lymphadenectomy. PATIENTS AND METHODS: The medical records from four institutions from 2004 to 2018 were reviewed and data for 91 patients with CY1, but no other distant metastases, who underwent gastrectomy were analyzed. D2 or greater lymphadenectomy and less than D2 lymphadenectomy were performed in 51 and 40 patients, respectively. RESULTS: Full cohort analyses showed that patients who underwent D2 or greater lymphadenectomy had better prognostic nutritional indices and more such patients received postoperative chemotherapy. The OS in the group treated with D2 or greater lymphadenectomy was also significantly better (p=0.045). Twenty-seven pairs of patients were generated via propensity score matching, and analysis of their OS showed no significant difference between the groups according to lymphadenectomy (p=0.61). CONCLUSION: The extent of lymphadenectomy may not affect the prognoses for patients with CY1 gastric cancer.


Assuntos
Excisão de Linfonodo/métodos , Neoplasias Gástricas/patologia , Neoplasias Gástricas/cirurgia , Idoso , Idoso de 80 Anos ou mais , Análise de Variância , Causas de Morte , Feminino , Gastrectomia/métodos , Gastrectomia/mortalidade , Humanos , Excisão de Linfonodo/mortalidade , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Peritônio/patologia , Prognóstico , Pontuação de Propensão , Estudos Retrospectivos , Estatísticas não Paramétricas , Neoplasias Gástricas/tratamento farmacológico , Neoplasias Gástricas/mortalidade , Taxa de Sobrevida , Fatores de Tempo
6.
Anticancer Res ; 39(11): 6249-6257, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31704854

RESUMO

BACKGROUND/AIM: Therapeutic targeting of receptor protein tyrosine kinases (PTKs) has proven successful in treating cancer. However, reports about PTKs in treating prostate cancer are few. Elevated expression of the erythropoietin-producing hepatocellular receptor A2 (EPHA2) receptor tyrosine kinase, a transmembrane protein, is associated with poor prognosis of certain cancer types when the enzyme is dephosphorylated. This study investigated whether EPHA2 is useful in predicting the biochemical recurrence of prostate cancer. PATIENTS AND METHODS: Data from 241 patients who had undergone total prostatectomy between 2007 and 2011 were used. EPHA2 protein expression was categorized as high or low by two pathologists. The relationship was examined between EPHA2 expression level (high vs. low) and clinicopathological factors including biochemical recurrence. Correlations were examined between EPHA2, low-molecular-weight protein tyrosine phosphatase (LMW-PTP), E-cadherin, and Ki-67. RESULTS: EPHA2 expression was high in 121 (50.2%) and low in 120 (49.8%) patients. A log-rank test revealed early biochemical recurrence in the high-expression group. Gleason score, Ki-67 labeling index, and biochemical recurrence were more frequent in the high-expression group. Furthermore, multivariate analyses revealed that high EPHA2 expression was an independent prognostic factor for biochemical recurrence (hazard ratio=3.62, 95% confidence interval=2.39-5.61). Correlations between EPHA2 and both LMW-PTP and Ki-67 labeling index were positive, whereas EPHA2 and E-cadherin were negatively correlated. CONCLUSION: EPHA2 overexpression is predictive of aggressive prostate cancer behavior. EPHA2 may be a powerful prognostic biomarker for decision-making in postoperative follow-up after total prostatectomy, and regarding the need for palliative treatment. Additionally, it may be an important therapeutic target.


Assuntos
Biomarcadores Tumorais/metabolismo , Efrina-A2/metabolismo , Proteínas de Neoplasias/metabolismo , Recidiva Local de Neoplasia/metabolismo , Neoplasias da Próstata/metabolismo , Idoso , Análise de Variância , Caderinas/metabolismo , Humanos , Estimativa de Kaplan-Meier , Antígeno Ki-67/metabolismo , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Recidiva Local de Neoplasia/patologia , Prostatectomia , Neoplasias da Próstata/patologia , Neoplasias da Próstata/cirurgia , Proteínas Tirosina Fosfatases/metabolismo , Curva ROC
7.
Anticancer Res ; 39(11): 6325-6332, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31704863

RESUMO

BACKGROUND/AIM: We aimed to assess surgical outcome and long-term survival after elective hepatic resection for hepatocellular carcinoma (HCC) and colorectal liver metastasis (CRLM) in patients aged 80 years or older. PATIENTS AND METHODS: This study included 100 patients aged 70 years or older, who underwent hepatic resection for HCC or CRLM between January 2000 and December 2012. Outcomes and clinicopathological data were compared between the elderly (aged 70-79 years; n=84) and extremely elderly groups (aged 80 years or older; n=16). RESULTS: Incidence of postoperative complications, in-hospital mortality, and postoperative OS in the extremely elderly group were comparable with those of the elderly group. In patients with HCC, the extremely elderly group was associated with shorter DFS (p=0.030) in univariate analysis, while multivariate analysis showed significant and independent factors of cancer recurrence. CONCLUSION: Hepatic resection for HCC and CRLM in patients aged 80 years and older may be safe and acceptable with appropriate selection. For HCC in patients aged 80 years and older, hepatic resection may be effective when negative surgical margins can be achieved.


Assuntos
Carcinoma Hepatocelular/cirurgia , Neoplasias Colorretais/patologia , Hepatectomia , Neoplasias Hepáticas/cirurgia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Análise de Variância , Carcinoma Hepatocelular/mortalidade , Carcinoma Hepatocelular/patologia , Comorbidade , Intervalo Livre de Doença , Feminino , Hepatectomia/mortalidade , Hepatectomia/estatística & dados numéricos , Mortalidade Hospitalar , Humanos , Estimativa de Kaplan-Meier , Neoplasias Hepáticas/mortalidade , Neoplasias Hepáticas/patologia , Neoplasias Hepáticas/secundário , Masculino , Margens de Excisão , Complicações Pós-Operatórias , Análise de Sobrevida , Resultado do Tratamento
8.
Anticancer Res ; 39(11): 6347-6353, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31704866

RESUMO

BACKGROUND/AIM: The aim of this study was to determine the significance of immunonutritional and physical index in the assessment of risk associated with pancreaticoduodenectomy (PD) in the elderly. PATIENTS AND METHODS: This study enrolled 92 patients who underwent PD. They were divided into 2 groups: Group A included patients 79 years and younger (n=79) and Group B patients 80 years and older (n=13). Among 37 patients, physical function and body composition were also evaluated. RESULTS: Significantly higher neutrophil-lymphocyte ratio, lower prognostic nutritional index (PNI), and controlling nutritional score were observed in Group B. Muscle strength and walking ability were significantly impaired in Group B, although there was no significant difference in body composition. Age was not correlated with the incidence of postoperative complications, overall survival or recurrence-free survival by univariate and multivariate analysis. CONCLUSION: PD is justified for the elderly, with acceptable morbidity and prognosis. However, immunonutritional status and physical function are significantly impaired; thus, appropriate case selection and active nutritional support are required for the elderly.


Assuntos
Limitação da Mobilidade , Força Muscular , Estado Nutricional , Pancreaticoduodenectomia/efeitos adversos , Complicações Pós-Operatórias , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Análise de Variância , Neoplasias dos Ductos Biliares/cirurgia , Composição Corporal , Comorbidade , Neoplasias Duodenais/cirurgia , Feminino , Humanos , Contagem de Leucócitos , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Neutrófilos/citologia , Avaliação Nutricional , Neoplasias Pancreáticas/cirurgia , Pancreaticoduodenectomia/mortalidade , Complicações Pós-Operatórias/epidemiologia , Estudos Retrospectivos , Medição de Risco , Albumina Sérica/análise
9.
Undersea Hyperb Med ; 46(5): 635-646, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31683362

RESUMO

We aimed to assess the effects of intermittent hyperbaric oxygenation (HBO2 at 2 bars for 120 minutes a day for four successive days) on acetylcholine-induced vasorelaxation (AChIR) in female Sprague-Dawley (SD) rats (N=80) that were randomized into four groups: healthy controls (CTR); diabetic rats (DM); and control and diabetic rats that underwent hyperbaric oxygenation (CTR+HBO and DM+HBO), respectively. AChIR was measured in vitro in aortic rings, with/without L-NAME, MS-PPOH, HET0016 or indomethacin. mRNA expression of eNOS, iNOS, COX-1, COX-2, thromboxane A synthase 1 (TBXAS1), CYP4A1, CYP4A3 and CYP2J3 was assessed by qPCR. Systemic oxidative stress and plasma antioxidative capacity were determined with the thiobarbituric acid-reactive substances (TBARS) and the ferric reducing ability of plasma (FRAP) assays, respectively. There was no significant difference in AChIR among experimental groups of rats. In CTR and DM group of rats, AChIR was mediated by NO and EETs pathway, while in the CTR+HBO and DM+HBO groups, NO-pathway prevailed. iNOS expression was upregulated in the DM group compared to CTR, while HBO2 upregulated eNOS in CTR group and TBXAS1 in DM group of rats. In both, CTR and DM group of rats, the sensitivity to ACh in the presence of L-NAME or in the presence of MSPPOH was significantly decreased compared to the response to ACh in the absence or presence of indomethacin or HET0016. DM and DM+HBO rats had increased TBARS compared to their respective controls. In conclusion, HBO2 presumably alters vasorelaxation in response to ACh from NO-EETs mediated pathways to solely NO-pathway, without affecting oxidative status of DM rats.


Assuntos
Acetilcolina/farmacologia , Inibidores das Enzimas do Citocromo P-450/farmacologia , Diabetes Mellitus Experimental/fisiopatologia , Oxigenação Hiperbárica , Vasodilatação/efeitos dos fármacos , Vasodilatadores/farmacologia , Análise de Variância , Animais , Aorta/efeitos dos fármacos , Aorta/fisiopatologia , Glicemia/análise , Peso Corporal , Sistema Enzimático do Citocromo P-450/fisiologia , Primers do DNA , Diabetes Mellitus Experimental/induzido quimicamente , Diabetes Mellitus Tipo 1/induzido quimicamente , Diabetes Mellitus Tipo 1/fisiopatologia , Feminino , Oxigenação Hiperbárica/métodos , Estresse Oxidativo , RNA Mensageiro/metabolismo , Ratos , Ratos Sprague-Dawley , Estreptozocina , Fatores de Tempo , Vasodilatação/fisiologia
10.
J Appl Oral Sci ; 27: e20180663, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31596368

RESUMO

OBJECTIVE: To investigate the use of polymethyl methacrylate (PMMA) electrospun fiber mats containing different amounts of polyethylene oxide (PEO) as a doxycycline delivery system and to test antibacterial activity against an oral pathogen. METHODOLOGY: PMMA powders or PEO (mol wt 200 Kd) (10,20,30% w/w/) were dissolved in N, N-dimethylformamide (DMF) to obtain a final polymer concentration of 15% in DMF (w/v). 2% Doxycycline monohydrate was added to the solutions and submitted to vortex mixing. The solution was transferred to a plastic syringe and fit into a nanofiber electrospinning unit. The parameters applied were: voltage at 17.2 kV; distance of 20 cm between the needle tip and the collector plate; target speed at 2 m/min; and transverse speed at 1cm/min. Syringe pump speed was 0.15 mm/min. The drug release analysis was performed by removing aliquots of the drug-containing solution (in PBS) at specific periods. Doxycycline release was quantified using RP-HPLC. Fiber mats from all groups had their antibacterial action tested against S. mutans based on inhibition halos formed around the specimens. The experiments were performed in triplicate. Gravimetric analysis at specific periods was performed to determine any polymer loss. Morphological characterization of the electrospun fibers was completed under an optical microscope followed by SEM analysis. RESULTS: The addition of PEO to the PMMA fibers did not affect the appearance and diameter of fibers. However, increasing the %PEO caused higher doxycycline release in the first 24 h. Fibers containing 30% PEO showed statistically significant higher release when compared with the other groups. Doxycycline released from the fibers containing 20% or 30% of PEO showed effective against S. mutans. CONCLUSION: The incorporation of PEO at 20% and 30% into PMMA fiber mat resulted in effective drug release systems, with detected antibacterial activity against S. mutans.


Assuntos
Antibacterianos/farmacocinética , Doxiciclina/farmacocinética , Nanofibras/química , Polietilenoglicóis/farmacocinética , Polimetil Metacrilato/farmacocinética , Análise de Variância , Antibacterianos/química , Cromatografia Líquida de Alta Pressão/métodos , Doxiciclina/química , Imersão , Microscopia Eletrônica de Varredura , Peso Molecular , Polietilenoglicóis/química , Polimetil Metacrilato/química , Reprodutibilidade dos Testes , Streptococcus mutans/efeitos dos fármacos , Fatores de Tempo , Água/química
11.
Bull Cancer ; 106(11): 983-999, 2019 Nov.
Artigo em Francês | MEDLINE | ID: mdl-31587802

RESUMO

INTRODUCTION: Osteosarcoma is the most common malignant bone tumor before 25 years of age. Response to neoadjuvant chemotherapy determines continuation of treatment and is also a powerful prognostic factor. There are currently no reliable ways to evaluate it early. The aim is to develop a method to predict the chemotherapy response using radiomics from pre-treatment MRI. METHODS: Clinical characteristics and MRI of patients treated for local or metastatic osteosarcoma were collected retrospectively in the Rhône-Alpes region, from 2007 to 2016. On initial MRI exams, each tumor was segmented by expert radiologist and 87 radiomic features were extracted automatically. Univariate analysis was performed to assess each feature's association with histological response following neoadjuvante chemotherapy. To distinguish good histological responder from poor, we built predictive models based on support vector machines. Their classification performance was assessed with the area under operating characteristic curve receiver (AUROC) from test data. RESULTS: The analysis focused on the MRIs of 69 patients, 55.1% (38/69) of whom were good histological responders. The model obtained by support vector machines from initial MRI radiomic data had an AUROC of 0.98, a sensitivity of 100% (IC 95% [100%-100%]) and specificity of 86% (IC 95% [59.7%-111%]). DISCUSSION: Radiomic based on MRI data would predict the chemotherapy response before treatment initiation, in patients treated for osteosarcoma.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/tratamento farmacológico , Aprendizado de Máquina , Imagem por Ressonância Magnética , Osteossarcoma/diagnóstico por imagem , Osteossarcoma/tratamento farmacológico , Adolescente , Análise de Variância , Neoplasias Ósseas/mortalidade , Neoplasias Ósseas/patologia , Quimioterapia Adjuvante , Criança , Pré-Escolar , Feminino , França , Humanos , Lactente , Recém-Nascido , Masculino , Terapia Neoadjuvante , Osteossarcoma/mortalidade , Osteossarcoma/patologia , Valor Preditivo dos Testes , Estudos Retrospectivos , Sensibilidade e Especificidade , Resultado do Tratamento , Adulto Jovem
12.
An Acad Bras Cienc ; 91(3): e20180447, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31576913

RESUMO

In this study effects of ultrasonic pretreatment with different sonication sources on drying behavior of carrot slices were evaluated. Fresh carrot slices were pretreated with ultrasonic probe at 65, 75 and 85 W or ultrasonic bath at 10, 20 and 30°C for 3, 5 and 10 min before air drying. Water gain % and solid loss % of pretreated samples were calculated and color values, ß-carotene content and rehydration ratios of dried samples were determined. Drying behavior of the pretreated samples was evaluated and the drying data were fitted to thin layer drying models. Constant drying rate period was not observed for the carrot slices; however two definite falling-rate periods having different slopes were obtained. Drying time was significantly reduced (up to 20%) depending on the type of pretreatment. The redness value, total color difference and Chroma values of pretreated and control samples were in the same group (p>0.05). ß-carotene content of ultrasonic bath pretreated samples were significantly higher than the samples pretreated with ultrasonic probe and the sample dried without any pretreatment as well (p<0.05). Also rehydration ratios of control samples were found lower than the ultrasound pretreated samples.


Assuntos
Daucus carota/efeitos da radiação , Manipulação de Alimentos/métodos , Qualidade dos Alimentos , Ondas Ultrassônicas , Algoritmos , Análise de Variância , Cor , Daucus carota/química , Cinética , Valores de Referência , Reprodutibilidade dos Testes , Sonicação/métodos , Fatores de Tempo , beta Caroteno/análise , beta Caroteno/efeitos da radiação
13.
Braz Oral Res ; 33(suppl 1): e065, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31576949

RESUMO

Additive manufacturing (AM) is an emerging process for biomaterials and medical devices. Direct Laser Metal Sintering (DLMS) is an AM technique used to fabricate Ti-6Al-4V implant materials with enhanced surface-related properties compared with wrought samples; thus, this technique could influence microbial adsorption and colonization. Therefore, this in vitro study was conducted to evaluate the impact of different implant production processes on microbial adhesion of periodontal pathogens. Titanium discs produced using two different processes-conventional and AM-were divided into three groups: conventional titanium discs with machined surface (G1), AM titanium discs with chemical treatment (G2) and AM titanium discs without chemical treatment (G3). Subgingival biofilm composed of 32 species was formed on the titanium discs, and positioned vertically in 96-well plates, for 7 days. The proportions of microbial complexes and the microbial profiles were analyzed using a DNA-DNA hybridization technique, and data were evaluated using Kruskal-Wallis and Dunnett tests (p < 0.05). Lower proportions of the red complex species were observed in the biofilm formed in G2 compared with that in G1 (p < 0.05). Moreover, the proportions of the microbial complexes were similar between G2 and G3 (p > 0.05). Compared with G1, G2 showed reduced levels of Porphyromonas gingvalis , Actinomyces gerencseriae, and Streptococcus intermedius , and increased levels of Parvimonas micra , Actinomyces odontolyticus, and Eikenella corrodens (p < 0.05). The microbial profile of G3 did not differ from G1 and G2 (p > 0.05). The results of this in vitro study showed that titanium discs produced via AM could alter the microbial profile of the biofilm formed around them. Further clinical studies should be conducted to confirm these findings.


Assuntos
Biofilmes/crescimento & desenvolvimento , Titânio/química , Titânio/farmacologia , Análise de Variância , Bactérias/efeitos dos fármacos , Biofilmes/efeitos dos fármacos , Sondas de DNA , Microscopia de Força Atômica , Microscopia Eletrônica de Varredura , Espectroscopia Fotoeletrônica , Valores de Referência , Reprodutibilidade dos Testes , Estatísticas não Paramétricas , Propriedades de Superfície , Fatores de Tempo
14.
Bone Joint J ; 101-B(10): 1230-1237, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31564152

RESUMO

AIMS: The aim of this study was to assess the effect of posterior cruciate ligament (PCL) resection on flexion-extension gaps, mediolateral soft-tissue laxity, fixed flexion deformity (FFD), and limb alignment during posterior-stabilized (PS) total knee arthroplasty (TKA). PATIENTS AND METHODS: This prospective study included 110 patients with symptomatic osteoarthritis of the knee undergoing primary robot-assisted PS TKA. All operations were performed by a single surgeon using a standard medial parapatellar approach. Optical motion capture technology with fixed femoral and tibial registration pins was used to assess gaps before and after PCL resection in extension and 90° knee flexion. Measurements were made after excision of the anterior cruciate ligament and prior to bone resection. There were 54 men (49.1%) and 56 women (50.9%) with a mean age of 68 years (sd 6.2) at the time of surgery. The mean preoperative hip-knee-ankle deformity was 4.1° varus (sd 3.4). RESULTS: PCL resection increased the mean flexion gap significantly more than the extension gap in the medial (2.4 mm (sd 1.5) vs 1.3 mm (sd 1.0); p < 0.001) and lateral (3.3 mm (sd 1.6) vs 1.2 mm (sd 0.9); p < 0.01) compartments. The mean gap differences after PCL resection created significant mediolateral laxity in flexion (gap difference: 1.1 mm (sd 2.5); p < 0.001) but not in extension (gap difference: 0.1 mm (sd 2.1); p = 0.51). PCL resection significantly improved the mean FFD (6.3° (sd 4.4) preoperatively vs 3.1° (sd 1.5) postoperatively; p < 0.001). There was a strong positive correlation between the preoperative FFD and change in FFD following PCL resection (Pearson's correlation coefficient = 0.81; p < 0.001). PCL resection did not significantly affect limb alignment (mean change in alignment: 0.2° valgus (sd 1.2); p = 0.60). CONCLUSION: PCL resection creates flexion-extension mismatch by increasing the flexion gap more than the extension gap. The increase in the lateral flexion gap is greater than the increase in the medial flexion gap, which creates mediolateral laxity in flexion. Improvements in FFD following PCL resection are dependent on the degree of deformity before PCL resection. Cite this article: Bone Joint J 2019;101-B:1230-1237.


Assuntos
Artroplastia do Joelho/métodos , Instabilidade Articular/prevenção & controle , Osteoartrite do Joelho/cirurgia , Ligamento Cruzado Posterior/cirurgia , Amplitude de Movimento Articular/fisiologia , Procedimentos Cirúrgicos Robóticos/métodos , Fatores Etários , Idoso , Análise de Variância , Artroplastia do Joelho/efeitos adversos , Estudos de Coortes , Feminino , Seguimentos , Humanos , Prótese do Joelho , Masculino , Pessoa de Meia-Idade , Osteoartrite do Joelho/diagnóstico por imagem , Cuidados Pós-Operatórios/métodos , Estudos Prospectivos , Melhoria de Qualidade , Medição de Risco , Procedimentos Cirúrgicos Robóticos/efeitos adversos , Fatores Sexuais , Resultado do Tratamento
15.
Bone Joint J ; 101-B(10): 1238-1247, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31564153

RESUMO

AIMS: Options for the treatment of intra-articular ligament injuries are limited, and insufficient ligament reconstruction can cause painful joint instability, loss of function, and progressive development of degenerative arthritis. This study aimed to assess the capability of a biologically enhanced matrix material for ligament reconstruction to withstand tensile forces within the joint and enhance ligament regeneration needed to regain joint function. MATERIALS AND METHODS: A total of 18 New Zealand rabbits underwent bilateral anterior cruciate ligament reconstruction by autograft, FiberTape, or FiberTape-augmented autograft. Primary outcomes were biomechanical assessment (n = 17), microCT (µCT) assessment (n = 12), histological evaluation (n = 12), and quantitative polymerase chain reaction (qPCR) analysis (n = 6). RESULTS: At eight weeks, FiberTape alone or FiberTape-augmented autograft demonstrated increased biomechanical stability compared with autograft regarding ultimate load to failure (p = 0.035), elongation (p = 0.006), and energy absorption (p = 0.022). FiberTape-grafted samples also demonstrated increased bone mineral density in the bone tunnel (p = 0.039). Histological evaluation showed integration of all grafts in the bone tunnels by new bone formation, and limited signs of inflammation overall. A lack of prolonged inflammation in all samples was confirmed by quantification of inflammation biomarkers. However, no regeneration of ligament-like tissue was observed along the suture tape materials. Except for one autograft failure, no adverse events were detected. CONCLUSION: Our results indicate that FiberTape increases the biomechanical performance of intra-articular ligament reconstructions in a verified rabbit model at eight weeks. Within this period, FiberTape did not adversely affect bone tunnel healing or invoke a prolonged elevation in inflammation. Cite this article: Bone Joint J 2019;101-B:1238-1247.


Assuntos
Lesões do Ligamento Cruzado Anterior/cirurgia , Reconstrução do Ligamento Cruzado Anterior/métodos , Polietilenos/química , Tendões/transplante , Resistência à Tração/fisiologia , Análise de Variância , Animais , Fenômenos Biomecânicos , Modelos Animais de Doenças , Feminino , Humanos , Peso Molecular , Coelhos , Sensibilidade e Especificidade , Estatísticas não Paramétricas , Técnicas de Sutura , Suturas , Transplante Autólogo
16.
Bone Joint J ; 101-B(10): 1218-1229, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31564157

RESUMO

AIMS: Abnormal femoral torsion (FT) is increasingly recognized as an additional cause for femoroacetabular impingement (FAI). It is unknown if in-toeing of the foot is a specific diagnostic sign for increased FT in patients with symptomatic FAI. The aims of this study were to determine: 1) the prevalence and diagnostic accuracy of in-toeing to detect increased FT; 2) if foot progression angle (FPA) and tibial torsion (TT) are different among patients with abnormal FT; and 3) if FPA correlates with FT. PATIENTS AND METHODS: A retrospective, institutional review board (IRB)-approved, controlled study of 85 symptomatic patients (148 hips) with FAI or hip dysplasia was performed in the gait laboratory. All patients had a measurement of FT (pelvic CT scan), TT (CT scan), and FPA (optical motion capture system). We allocated all patients to three groups with decreased FT (< 10°, 37 hips), increased FT (> 25°, 61 hips), and normal FT (10° to 25°, 50 hips). Cluster analysis was performed. RESULTS: We found a specificity of 99%, positive predictive value (PPV) of 93%, and sensitivity of 23% for in-toeing (FPA < 0°) to detect increased FT > 25°. Most of the hips with normal or decreased FT had no in-toeing (false-positive rate of 1%). Patients with increased FT had significantly (p < 0.001) more in-toeing than patients with decreased FT. The majority of the patients (77%) with increased FT walk with a normal foot position. The correlation between FPA and FT was significant (r = 0.404, p < 0.001). Five cluster groups were identified. CONCLUSION: In-toeing has a high specificity and high PPV to detect increased FT, but increased FT can be missed because of the low sensitivity and high false-negative rate. These results can be used for diagnosis of abnormal FT in patients with FAI or hip dysplasia undergoing hip arthroscopy or femoral derotation osteotomy. However, most of the patients with increased FT walk with a normal foot position. This can lead to underestimation or misdiagnosis of abnormal FT. We recommend measuring FT with CT/MRI scans in all patients with FAI. Cite this article: Bone Joint J 2019;101-B:1218-1229.


Assuntos
Artroscopia/métodos , Impacto Femoroacetabular/cirurgia , Imagem Tridimensional , Metatarso Valgo/diagnóstico por imagem , Metatarso Varo/diagnóstico por imagem , Osteotomia/efeitos adversos , Adulto , Análise de Variância , Distribuição de Qui-Quadrado , Estudos de Coortes , Feminino , Impacto Femoroacetabular/diagnóstico por imagem , Fêmur/fisiopatologia , Seguimentos , Humanos , Modelos Lineares , Imagem por Ressonância Magnética/métodos , Masculino , Metatarso Valgo/epidemiologia , Metatarso Varo/epidemiologia , Pessoa de Meia-Idade , Osteotomia/métodos , Prevalência , Amplitude de Movimento Articular/fisiologia , Estudos Retrospectivos , Medição de Risco , Fatores de Tempo , Tomografia Computadorizada por Raios X/métodos , Anormalidade Torcional/diagnóstico por imagem , Resultado do Tratamento , Adulto Jovem
17.
Hypertension ; 74(5): 1152-1159, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31564164

RESUMO

Microarray comparison of the transcriptomes of human adrenal zona glomerulosa (ZG) and zona fasciculata found several ZG-specific genes that negatively regulate aldosterone secretion. The third and most significantly upregulated ZG-gene (19.9-fold compared with zona fasciculata, P=6.58×10-24) was ANO4, a putative Ca2+-activated chloride channel. We have investigated the role of ANO4 in human adrenal, and whether it functions like the prototype anoctamin, ANO1. We evaluated ANO4 mRNA and protein expression in human adrenal by qPCR and immunohistochemistry, compared the effects of ANO4 and ANO1 overexpression on baseline and stimulated aldosterone secretion and cell proliferation in H295R cells, and analyzed ANO4 activity as a Ca2+-activated chloride channel in comparison with other anoctamins by a fluorescence-based functional assay. The expression of ANO4 in ZG was confirmed by qPCR as 23.21-fold upregulated compared with zona fasciculata (n=18; P=4.93×10-7). Immunohistochemistry found cytoplasmic, ZG-selective expression of ANO4 (anoctamin 4) protein. ANO4 overexpression in H295R cells attenuated calcium-mediated aldosterone secretion and cell proliferation in comparison to controls. The latter effects were in a different direction to those of ANO1. The functional assay showed that, in contrast to ANO1, ANO4 expression results in low levels of calcium-dependent anion transport. In conclusion, ANO4 is one of the most highly expressed genes in ZG. It attenuates stimulated aldosterone secretion and cell proliferation. Although belonging to a family of Ca2+-activated chloride channels, it does not generate significant plasma membrane chloride channel activity.


Assuntos
Aldosterona/biossíntese , Anoctaminas/genética , Regulação da Expressão Gênica , Hiperaldosteronismo/genética , Hipertensão/fisiopatologia , Transdução de Sinais/genética , Córtex Suprarrenal/citologia , Córtex Suprarrenal/metabolismo , Córtex Suprarrenal/patologia , Análise de Variância , Comunicação Celular/genética , Proliferação de Células , Células Cultivadas , Imunofluorescência , Humanos , Hiperaldosteronismo/patologia , Hipertensão/etiologia , Reação em Cadeia da Polimerase em Tempo Real/métodos , Análise Serial de Tecidos , Técnicas de Cultura de Tecidos , Transcriptoma/genética , Regulação para Cima , Zona Fasciculada/metabolismo , Zona Fasciculada/patologia , Zona Glomerulosa/metabolismo , Zona Glomerulosa/patologia
18.
Medicine (Baltimore) ; 98(43): e17325, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31651838

RESUMO

BACKGROUND: Pain stemming from the placement of elastomeric separators and the exchanging of wires and accessories is the greatest reason for abandoning orthodontic treatment. Indeed, discomfort related to treatment exerts a negative impact on quality of life due to the difficulty chewing and biting. This paper proposes a study to evaluate the analgesic effects of photomiobodulation (PBM) on individuals undergoing orthodontic treatment. METHODS: The sample will be composed of 72 individuals who receiving elastomeric separators on the mesial and distal faces of the maxillary first molars. The patients will be randomly allocated to 2 groups: an experimental group irradiated with low-level laser and a sham group submitted to simulated laser irradiation. Upon the placement of the separators, the experimental group will receive a single application of PBM on the mesial and distal cervical portion and apical third of the molars. Perceived pain will be analyzed after one hour using the visual analog scale in both groups. Samples will be taken of the gingival crevice with absorbent paper for 30 seconds for the analysis of cytokines using ELISA and the results of the 2 groups will be compared. The patients will sign a statement of informed consent. Statistical analysis will be performed with the Student's t test and analysis of variance (ANOVA). DISCUSSION: The expectation is that the patients in the irradiated group will have a lower perception of pain and lower quantity of cytokines compared to those in the sham group. The purpose of the study is to establish an effective method for PBM with the use of low-level infrared laser (Ga-Al-As with a wavelength of 808 nm and output power of 100 mW) for reductions in pain and inflammatory cytokines related to orthodontic treatment. TRIAL REGISTRATION: This protocol was registered in ClinicalTrial.gov, under number NCT03939988. It was first posted and last updated in May 6, 2019.


Assuntos
Elastômeros/efeitos adversos , Terapia com Luz de Baixa Intensidade/métodos , Aparelhos Ortodônticos/efeitos adversos , Dor Processual/terapia , Técnicas de Movimentação Dentária/efeitos adversos , Adolescente , Adulto , Análise de Variância , Feminino , Humanos , Masculino , Dente Molar , Medição da Dor , Dor Processual/etiologia , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento , Adulto Jovem
19.
Braz Oral Res ; 33: e097, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31664360

RESUMO

To evaluate the torsional properties of engine-driven pathfinding instruments manufactured from different NiTi alloys - R-Pilot (tip size 12.5;.04 taper; M-Wire) and One G (tip size 14;.03 taper; Conventional NiTi). A total of 40 NiTi instruments from engine-driven pathfinding instruments (n = 20) were used. The torsion tests followed ISO 3630-1 (1992). Three millimeters of each instrument tip was fastened to a small load cell by a lever arm linked to the axis of torsion. During the test, the torsion testing machine software measured the maximum torsional strength and angle of rotation (0) before instrument failure. The fractured surface of each instrument was assessed by scanning electron microscopy (SEM). In addition, a supplementary examination was performed to measure the cross-sectional area and the metal mass volume of each instrument 3 mm from the tip. Data were analyzed using a t-test, with significance level set at 5%. R-pilot had significantly higher torsional strength than did One G (p < 0.05). Regarding the angle of rotation to fracture, One G had higher angles than did R-Pilot (p < 0.05). The supplementary examination showed that R-Pilot had the highest cross-sectional area and volume of metal mass at 3 mm from the tip (p < 0.05). R-pilot (M-Wire NiTi alloy) had a significantly higher torsional strength and One-G (superelastic NiTi alloy) had the highest angle of rotation to fracture.


Assuntos
Ligas/química , Ligas Dentárias/química , Instrumentos Odontológicos , Preparo de Canal Radicular/instrumentação , Análise de Variância , Desenho de Equipamento , Análise de Falha de Equipamento , Teste de Materiais , Microscopia Eletrônica de Varredura , Valores de Referência , Reprodutibilidade dos Testes , Estatísticas não Paramétricas , Estresse Mecânico , Propriedades de Superfície , Torque
20.
Braz Oral Res ; 33: e098, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31664361

RESUMO

The aim was to evaluate the effect of 2% grape seed extract (GSE) containing phosphoric acid (PhA) on the bond strength to enamel and dentin. The control group was 37% PhA. The following three PhA formulations with 2% GSE and 20% ethanol were obtained: GSE5 = 5% PhA; GSE10 = 10% PhA; and GSE20 = 20% PhA. The enamel and dentin surfaces of molars were etched with the acid solutions, followed by Scotchbond Multi-Purpose adhesive and composite resin application. The tensile bond strength (TBS) test evaluated the bond to enamel after 24 h, and the microtensile bond strength (µTBS) test evaluated the bond to dentin after 24 h and 12-month water storage. Etched enamel and dentin were observed by scanning electron microscopy (SEM) and atomic force microscopy (AFM), respectively. The TBS data were submitted to one-way ANOVA, while µTBS data were submitted to two-way ANOVA and Tukey's test (α = 0.05). The TBS (MPa) to enamel did not significantly differ among the control (48.1 ± 15.7), GSE5 (46.1 ± 9.6), GSE10 (49.8 ± 13.6) and GSE20 (44.1 ± 11.9) groups (p = 0.537). The µTBS (MPa) to dentin of the control (28.4 ± 14.4) and GSE20 (24.1 ± 8.1) groups were significantly higher than those of the GSE5 (16.8 ± 7.4) and GSE10 (17.5 ± 6.6) groups at 24 h (p < 0.006). After 12-month storage, only GSE5 (21.0 ± 7.8) and GSE10 (17.6 ± 8.0) did not show significantly decreased µTBS (p > 0.145). SEM micrographs showed a shallower enamel etching pattern for GSE5. AFM images showed the formation of collagenous globular structures for GSE5 and GSE10. The different acid solutions did not influence the TBS to enamel, and the µTBS to dentin was stable over time when dentin was etched with GSE5 and GSE10.


Assuntos
Ataque Ácido Dentário/métodos , Colagem Dentária/métodos , Esmalte Dentário/efeitos dos fármacos , Dentina/efeitos dos fármacos , Extrato de Sementes de Uva/química , Ácidos Fosfóricos/química , Adolescente , Adulto , Análise de Variância , Esmalte Dentário/química , Dentina/química , Humanos , Teste de Materiais , Microscopia de Força Atômica , Microscopia Eletrônica de Varredura , Valores de Referência , Reprodutibilidade dos Testes , Estatísticas não Paramétricas , Propriedades de Superfície/efeitos dos fármacos , Resistência à Tração , Fatores de Tempo , Adulto Jovem
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