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1.
Hum Reprod ; 39(5): 1089-1097, 2024 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-38531673

RESUMO

STUDY QUESTION: How does a natural proliferative phase (NPP) strategy for frozen embryo transfer (FET) compare with the conventional artificial (AC) and natural (NC) endometrial preparation protocols in terms of live birth rates (LBR)? SUMMARY ANSWER: This study supports the hypothesis that, just as for NC, NPP-FET may be a superior alternative to AC in terms of LBR. WHAT IS KNOWN ALREADY: Although FETs are increasing worldwide, the optimal FET protocol is still largely controversial. Despite recent evidence supporting a possibly higher efficacy and safety of NC FETs, their widespread use is limited by the difficulties encountered during cycle monitoring and scheduling. STUDY DESIGN, SIZE, DURATION: In this single center retrospective cohort study, we describe the NPP-FET protocol, in which vaginal progesterone is initiated during the proliferative phase as soon as an endometrium with a thickness of at least 7 mm is identified and ovulation is ruled out, regardless of mean diameter of the dominant follicle. PARTICIPANTS/MATERIALS, SETTING, METHODS: For comparison, we considered all blastocyst stage FET cycles preformed at a private infertility center between January 2010 and June 2022, subdivided according to the following subgroups of endometrial preparation: AC, NPP, and NC. We performed multivariable generalized estimating equations regression analysis to account for the following potential confounding variables: oocyte age at retrieval, oocyte source (autologous without preimplantation genetic testing for aneuploidies (PGT-A) versus autologous with PGT-A versus donated), number of oocytes retrieved/donated, embryo developmental stage (Day 5 versus Day 6), number of embryos transferred, quality of the best embryo transferred, and year of treatment. The main outcome measure was LBR. The secondary outcomes included hCG positive, clinical pregnancy and miscarriage rates, and the following perinatal outcomes: first trimester bleeding, second/third trimester bleeding, preterm rupture of membranes, gestational diabetes, gestational hypertensive disorders (GHD), and gestational age at delivery. MAIN RESULTS AND THE ROLE OF CHANCE: A total of 5791 FET cycles were included in this analysis (2226 AC, 349 NPP, and 3216 NC). The LBR for FET was lower in the AC subgroup when compared to the NPP and NC (38.4%, 49.1%, and 45.2%, respectively; P < 0.01 AC versus NPP and AC versus NC). The rates of miscarriage were also lower in the NPP and NC subgroups when compared to AC (19.7%, 25.0%, and 34.9%, respectively; P < 0.01 NPP versus AC and NC versus AC). Considering perinatal outcomes, NPP-FET and NC were associated with a significantly lower first trimester bleeding compared to AC (17.3%, 14.7%, and 37.6%, respectively; P < 0.01 NPP versus AC and NC versus AC). Additionally, NC was associated with a lower rate of GHD when compared with AC (8.6% versus 14.5%, P < 0.01), while the rate following NPP-FET was 9.4%. LIMITATIONS, REASONS FOR CAUTION: This study is limited by its retrospective design. Moreover, there was also a low number of patients in the NPP subgroup, which may have led the study to be underpowered to detect clinically relevant differences between the subgroups. WIDER IMPLICATIONS OF THE FINDINGS: Our study posits that the NPP-FET protocol may be an effective and safe alternative to both NC and AC, while still allowing for enhanced practicality in patient follow-up and FET scheduling. Further investigation on NPP-FET is warranted, with prospective studies including a larger and more homogeneous subsets of patients. STUDY FUNDING/COMPETING INTEREST(S): This research was supported by the IVI-RMA-Lisbon (2008-LIS-053-CG). The authors did not receive any funding for this study. The authors have no competing interests. TRIAL REGISTRATION NUMBER: Not applicable.


Assuntos
Criopreservação , Transferência Embrionária , Resultado da Gravidez , Humanos , Feminino , Gravidez , Transferência Embrionária/métodos , Estudos Retrospectivos , Adulto , Criopreservação/métodos , Taxa de Gravidez , Coeficiente de Natalidade , Nascido Vivo , Endométrio , Progesterona , Indução da Ovulação/métodos , Fertilização in vitro/métodos
2.
J Sex Med ; 19(5): 738-744, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35341724

RESUMO

INTRODUCTION: Radial wave therapy is commercialized as an option for the management of erectile dysfunction. However, the mechanism of action of the radial waves differs substantially from shock waves, so the evidence gathered for shock wave therapy cannot be extrapolated, and there are very few clinical trials with the radial wave. AIM: To assess the efficacy and safety of radial wave therapy compared with sham therapy for the treatment of moderate and mild to moderate erectile dysfunction. METHODS: A randomized, double-blind, sham-controlled clinical trial was realized. Eighty patients with moderate erectile dysfunction, without sickle cell anemia, anticoagulation treatment, comorbidities, or conditions associated with secondary erectile dysfunction were included. The efficacy and safety were assessed at 6 and 10 weeks after randomization. Patients were randomized 1:1 to 1 of 2 arms: (i) 6 weekly sessions of radial wave therapy (RW group) or (ii) 6 weekly sessions of sham therapy (control group). All patients received sildenafil 25 mg. OUTCOME: The primary outcome was the mean change in the International Index of Erectile Function - Erectile Function (IIEF-EF) domain score at 6 weeks after randomization. RESULTS: Eighty men were randomized. The average baseline IIEF-EF score was 16.3 (Standard Deviation - SD 3.2), and the median baseline Erection Hardness Score (EHS) was 3 (IQR 1). At 6 weeks after randomization, the mean change in the IIEF-EF score was 3.4 (95% confidence interval [CI] 1.5-5.2) in the RW group and 4.2 (95% CI 2.5-5.9) in the control group. No differences were observed between groups (P value =.742). No change was observed in the median EHS score in the evaluations. No serious adverse events occurred in 2 (5%) patients after radial wave therapy, and in 1 (2.5%) patient after sham therapy. CLINICAL IMPLICATIONS: Knowledge of the effectiveness of radial waves protocols used for the treatment of moderate erectile dysfunction, helps doctors and patients in making decisions about the use of this therapy. STRENGTHS & LIMITATIONS: One strength is conducting the study with high methodological standards to minimize risk biases. Our results are limited to the evaluation of 1 specific protocol in moderate and mild to moderate erectile dysfunction. CONCLUSIONS: No difference was found in this study between men with moderate and mild to moderate erectile dysfunction treated with radial waves and men treated with placebo sham therapy. Studies with different protocols of radial waves are necessary. Sandoval-Salinas C, Saffon JP, Martínez JM, et al. Are Radial Pressure Waves Effective for the Treatment of Moderate or Mild to Moderate Erectile Dysfunction? A Randomized Sham Therapy Controlled Clinical Trial. J Sex Med 2022;19:738-744.


Assuntos
Disfunção Erétil , Tratamento por Ondas de Choque Extracorpóreas , Método Duplo-Cego , Tratamento por Ondas de Choque Extracorpóreas/métodos , Humanos , Masculino , Ereção Peniana/fisiologia , Citrato de Sildenafila/uso terapêutico , Resultado do Tratamento
3.
J Org Chem ; 87(20): 13427-13438, 2022 10 21.
Artigo em Inglês | MEDLINE | ID: mdl-36075104

RESUMO

Three new single-crystal structures were isolated for picolinic acid (2), the trifluoroacetate salt of picolinic acid (1), and pyridoxal hydrochloride (3). These compounds displayed unconventional crystallographic features that must be considered when structural refinements are carried out. Thus, the generated Fourier differences map obtained with the diffraction data collected at 100 K was crucial to visualize electron densities, which were balanced by either one hydrogen atom or a hydrogen atom with an occupancy factor of 1/2 located between either two carboxylate moieties, two phenolic oxygen atoms, or two pyridinic nitrogen atoms. Moreover, NMR studies were conducted to analyze the bulk chemical composition of single crystals of 2-pyridinecarboxylic acid obtained from the gem-diol/hemiacetal forms and the polymerization products after the treatment of 2-pyridinecarboxaldehyde with TFA:H2O (1) or a diluted Cu(NO3)2 solution (2). The quantitative yield of the pyridoxal hydrochloride crystalline material (3) obtained from a diluted CuCl2 solution was exhaustively characterized by solid-state NMR methods. These methods allowed the resolution of the signals corresponding to the protons of the hydroxyl moiety of the intramolecular hemiacetal group and the phenolic hydrogen. Theoretical calculations using DFT methods were done to complement the atomic location of the hydrogen atoms obtained from the X-ray analysis.


Assuntos
Hidrogênio , Piridoxal , Cristalografia por Raios X , Piridoxal/química , Ligação de Hidrogênio , Estrutura Molecular , Prótons , Ácido Trifluoracético , Oxigênio , Nitrogênio
4.
J Invertebr Pathol ; 194: 107803, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-35931180

RESUMO

Collecting entomopathogenic fungi associated with mosquitoes and studies on their activity against mosquito developmental stages will improve the understanding of their potential as agents to control important mosquito vectors. Twenty-one strains of entomopathogenic fungi affecting mosquitoes in Central Brazil were studied: 7 of Beauveria bassiana, 7 of Metarhizium humberi, 3 of M. anisopliae, 2 of Cordyceps sp. and one each of Akanthomyces saksenae and Simplicillium lamellicola. These fungi were isolated from field-collected mosquito adults (3 strains) or larvae (a single strain); the other 17 strains were isolated from laboratory-reared Aedes aegypti sentinel larvae set out in partially immersed cages placed in diverse small- to middle-sized aquatic mosquito habitats in or close to areas with secondary tropical forest. The frequent recovery of normally soil-borne Metarhizium spp. and B. bassiana from aquatic habitats is notable. Our laboratory findings indicated that M. anisopliae IP 429 and IP 438 and M. humberi IP 421 and IP 478 were highly active against immature stages and, together with M. anisopliae IP 432, also against adults. These strains appear to be the most promising candidates to develop effective control strategies targeting the different developmental stages of A. aegypti, the most important vector of viral diseases in humans in the tropics.


Assuntos
Aedes , Beauveria , Metarhizium , Aedes/microbiologia , Animais , Brasil , Ecossistema , Humanos , Larva , Controle de Mosquitos , Controle Biológico de Vetores , Solo
5.
Parasitol Res ; 121(10): 2979-2984, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35994116

RESUMO

Aedes aegypti (Linnaeus, 1762) is an important vector of arboviruses in the tropics and subtropics. New control strategies based on natural enemies such as entomopathogenic fungi are of utmost importance, and the present study reports the first isolation of Clonostachys spp. (Hypocreales: Bionectriaceae) from mosquitoes and their activity against A. aegypti. Entomopathogenic fungi were surveyed in central Brazil using A. aegypti larvae as sentinels and, also, a CDC light trap. Clonostachys eriocamporesii R.H. Perera & K.D. Hyde, 2020 (IP 440) and Clonostachys byssicola Schroers, 2001 (IP 461) were identified by sequence analysis of the nuclear ribosomal internal transcribed spacer gene, and tested against eggs, larvae, and adults. Both strains were highly active against A. aegypti third instar larvae, with mortalities ≥ 80% at 107 conidia/mL after 5 days but distinctly less active against eggs and adults. This is the first report of both C. eriocamporesii and C. byssicola as naturally occurring pathogens affecting mosquitoes, and IP 440 appears to be a promising control agent against aquatic stages of A. aegypti.


Assuntos
Aedes , Hypocreales , Aedes/microbiologia , Animais , Larva/microbiologia , Controle de Mosquitos , Mosquitos Vetores , Esporos Fúngicos
6.
Appl Microbiol Biotechnol ; 105(23): 8703-8714, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34716787

RESUMO

Entomopathogenic fungi can achieve important innovative outcomes for integrated mosquito control especially of Aedes aegypti, the key vector of arboviruses to humans in the tropics and subtropics. This study sought to design and to develop a simple dissemination device to attract and to infect gravid A. aegypti adults with a granular formulation of the ascomycete Metarhizium humberi IP 46, and to validate this device in the laboratory as well as in semi-field and field conditions. Hydrogel (polyacrylamide potassium polyacrylate) was confirmed to be a suitable substitute for water used in the device that attracted gravid females under field conditions. Females laid eggs on black polyethylene terephthalate carpet fixed in the device that also proved to be a suitable substrate for a granular formulation of fungal microsclerotia and/or conidia. The plastic device (29.5 cm high) was divided into a lower closed compartment with a water reservoir and an upper, laterally open but covered compartment with continuously hydrated gel and the fungal formulation attached to the carpet. The uppermost compartment permitted free circulation of mosquito adults. The device attracted both male and female A. aegypti. The fungal formulations of IP 46 propagules tested in the device were effective against adults in laboratory, semi-field, and field settings. Findings in the laboratory, semi-field, and especially in field conditions strengthen the value and utility of this innovative device for focal applications of a mycoinsecticide against this important mosquito vector.Key points• Low-cost and simple disseminating device for focal control of Aedes aegypti.• Granulized Metarhizium humberi IP 46 and hydrogel yield extended control.• Findings in field tests strengthen benefit of the device for focal application.


Assuntos
Aedes , Metarhizium , Animais , Brasil , Feminino , Humanos , Masculino , Mosquitos Vetores
7.
Compr Rev Food Sci Food Saf ; 19(2): 530-552, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-33325176

RESUMO

Microorganisms (bacteria, yeast, and microalgae) are a promising resource for products of high value such as nutrients, pigments, and enzymes. The majority of these compounds of interest remain inside the cell, thus making it necessary to extract and purify them before use. This review presents the challenges and opportunities in the production of these compounds, the microbial structure and the location of target compounds in the cells, the different procedures proposed for improving extraction of these compounds, and pulsed electric field (PEF)-assisted extraction as alternative to these procedures. PEF is a nonthermal technology that produces a precise action on the cytoplasmic membrane improving the selective release of intracellular compounds while avoiding undesirable consequences of heating on the characteristics and purity of the extracts. PEF pretreatment with low energetic requirements allows for high extraction yields. However, PEF parameters should be tailored to each microbial cell, according to their structure, size, and other factors affecting efficiency. Furthermore, the recent discovery of the triggering effect of enzymatic activity during cell incubation after electroporation opens up the possibility of new implementations of PEF for the recovery of compounds that are bounded or assembled in structures. Similarly, PEF parameters and suspension storage conditions need to be optimized to reach the desired effect. PEF can be applied in continuous flow and is adaptable to industrial equipment, making it feasible for scale-up to large processing capacities.


Assuntos
Bactérias/química , Eletricidade , Microalgas/química , Leveduras/química , Membrana Celular , Eletroporação/métodos
8.
Food Microbiol ; 73: 67-72, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29526228

RESUMO

The influence of temperature (7-43 °C), pH (3.5-7.0) and ethanol concentration (6-25%) on PEFinduced autolysis and the release of mannose from Saccharomyces cerevisiae was investigated. Changes in the release of intracellular compounds absorbing at 260 nm and 280 nm depended on storage conditions and differed among untreated and PEF-treated cells. For untreated cells, the increase of the Abs260 and Abs280 values during 3 weeks of storage was very low when incubated in media of different pH, different ethanol concentrations, or at 7° and 25 °C. Conversely, Abs260 and Abs280 values progressively increased for PEF-treated cells stored under the same conditions. Although the PEF treatment intensity was the same in all cases, the amount of intracellular material released depended on incubation conditions. Except for cells stored at 43 °C, for which the concentration of mannose in the media after 21 days was around 90 mg L-1, the amount of mannose released from untreated cells after 21 days of storage was lower than 60 mg L-1 under all other conditions assayed. After the same incubation time, the amount of mannose released from PEF treated cells ranged from 80 mg L-1, when they were stored in media with 25% ethanol, to 190 mg L-1 when they were stored at 43 °C. Interaction among assayed factors affecting mannose release was investigated in a medium containing 10% ethanol (v/v) and pH 3.5 for 21 days. Although the interaction of both factors delayed mannose release, the medium containing PEF-treated yeasts had approximately twice the amount of mannoproteins as those containing untreated yeasts.


Assuntos
Saccharomyces cerevisiae/química , Saccharomyces cerevisiae/citologia , Meios de Cultura/química , Meios de Cultura/metabolismo , Eletricidade , Concentração de Íons de Hidrogênio , Manose/metabolismo , Viabilidade Microbiana , Saccharomyces cerevisiae/crescimento & desenvolvimento , Saccharomyces cerevisiae/metabolismo , Temperatura
9.
Fish Physiol Biochem ; 42(3): 1027-42, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26762321

RESUMO

Turbot specimens were kept at three temperatures (T s ): warm (W) (21-22 °C), ambient (A) (17-18 °C) and cold (C) (13-14 °C) during the larval and early postlarval stages. At 90 days posthatching (dph), all of them were transferred to ambient T until 190 dph. At 2-3 dph, the specimens showed a monolayer of red muscle and immature white fibres; external or dermomyotome cells (presumptive myogenic cells) were observed on the surface of the red muscle. In the following stages, many myogenic cells and presumptive myogenic precursors were observed within the myotome, presumably derived of the dermomyotome. When comparing the growth at the same age (2, 10, 25, 37 dph), the body length and the muscle growth were positively influenced by the warm T, being the hyperplasia the muscle parameter more significantly influenced. The development rate was also positively correlated with the high T: the beginning of the metamorphosis took place at 15, 23 and 25 dph at W, A and C temperatures, respectively, with the highest body length values at ambient temperature. The metamorphosis finished at 25, 30 and 37 dph at W, A and C temperatures, respectively, with the highest body length values at warm temperature. However, the muscle cellularity was similar in all the groups at the end of the metamorphosis. At 90 and 190 dph, the largest body length was observed at W temperature. However, the muscle cellularity was similar between A and W; the number of fibres was similar in all the groups at 190 dph, which shows the beginning of a compensatory muscle growth in A and C, mainly in A.


Assuntos
Linguados/crescimento & desenvolvimento , Larva/crescimento & desenvolvimento , Desenvolvimento Muscular , Temperatura , Animais , Metamorfose Biológica , Microscopia Eletrônica de Transmissão , Músculos/anatomia & histologia , Músculos/ultraestrutura
10.
Small ; 11(1): 119-25, 2015 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-25115837

RESUMO

Efficient use of membrane protein nanopores in ionic single-molecule sensing requires technology for the reliable formation of suspended molecular membranes densely arrayed in formats that allow high-resolution electrical recording. Here, automated formation of bimolecular lipid layers is shown using a simple process where a poly(tetrafluoroethylene)-coated magnetic bar is remotely actuated to perform a turning motion, thereby spreading phospholipid in organic solvent on a nonpolar surface containing a <1 mm(2) 4 × 4 array of apertures with embedded microelectrodes (microelectrode cavity array). Parallel and high-resolution single-molecule detection by single nanopores is demonstrated on the resulting bilayer arrays, which are shown to form by a classical but very rapid self-assembly process. The technique provides a robust and scalable solution for the problem of reliable, automated formation of multiple independent lipid bilayers in a dense microarray format, while preserving the favorable electrical properties of the microelectrode cavity array.


Assuntos
Proteínas Hemolisinas/química , Bicamadas Lipídicas/química , Análise em Microsséries/métodos , Nanoporos , Automação , Eletricidade , Íons , Cinética , Microeletrodos
11.
J Urol ; 193(4): 1144-50, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25444981

RESUMO

PURPOSE: Several risk factors have been claimed to predict the progression of clinically high grade T1 bladder tumors. However, these factors are not specific enough to define which patients should be treated immediately with radical cystectomy. Therefore, it is critical to identify molecular markers that can help provide individualized, risk stratified decision making. Our main goal was to evaluate the role of total p63, p53 and ΔNp63 expression in cases of clinically high grade T1 bladder cancer progression. MATERIALS AND METHODS: Total p63, p53 and ΔNp63 expression was analyzed by immunohistochemistry in 134 clinically high grade T1 tumors. We assessed clinical progression to muscle invasive disease or radical cystectomy as a patient outcome end point. Survival analysis was done for recurrence-free, progression-free, disease specific and overall survival. RESULTS: A total of 132 patients (98.5%) underwent repeat transurethral resection. Cases of early progression (less than 3 months) were excluded from study to avoid under staging. Of the tumors 90 (67.2%) showed ΔNp63 expression loss. During a median followup of 62.1 months 19 patients (14.2%) progressed to muscle invasive disease. The progression rate was 21.1% in patients with tumors characterized by ΔNp63 loss but no progression was observed in those with tumors with ΔNp63 expression (p <0.001). There was no difference in the number of patients who underwent repeat transurethral resection, had associated carcinoma in situ, showed lymphovascular invasion or received followup intravesical bacillus Calmette-Guérin courses. CONCLUSIONS: ΔNp63 expression is a favorable prognostic factor in clinically high grade T1 bladder cancer. This marker identifies patients at low risk for progression who could benefit from conservative therapy with transurethral bladder tumor resection and bacillus Calmette-Guérin, avoiding over treatment with immediate radical cystectomy.


Assuntos
Biomarcadores Tumorais/biossíntese , Fatores de Transcrição/biossíntese , Proteínas Supressoras de Tumor/biossíntese , Neoplasias da Bexiga Urinária/metabolismo , Neoplasias da Bexiga Urinária/patologia , Biomarcadores Tumorais/análise , Progressão da Doença , Feminino , Humanos , Imuno-Histoquímica , Masculino , Gradação de Tumores , Fatores de Proteção , Fatores de Transcrição/análise , Proteínas Supressoras de Tumor/análise , Neoplasias da Bexiga Urinária/química
12.
Artigo em Inglês | MEDLINE | ID: mdl-38842969

RESUMO

BACKGROUND: Women respond more favorably to biventricular pacing (BIVP) than men. Sex differences in atrioventricular and interventricular conduction have been described in BIVP studies. Left bundle branch area pacing (LBBAP) offers advantages due to direct capture of the conduction system. We hypothesized that men could respond better to LBBAP than BIVP. OBJECTIVES: This study aims to describe the sex differences in response to LBBAP vs BIVP as the initial cardiac resynchronization therapy (CRT). METHODS: In this multicenter prospective registry, we included patients with left ventricular ejection fraction ≤35% and left bundle branch block or a left ventricular ejection fraction ≤40% with an expected right ventricular pacing exceeding 40% undergoing initial CRT with LBBAP or BIVP. The composite primary outcome was heart failure-related hospitalization and all-cause mortality. The primary safety outcome included all procedure-related complications. RESULTS: There was no significant difference in the primary outcome when comparing men and women receiving LBBAP (P = 0.46), whereas the primary outcome was less frequent in women in the BIVP group than men treated with BIVP (P = 0.03). The primary outcome occurred less frequently in men undergoing LBBAP (29.9%) compared to those treated with BIVP (46.5%) (P = 0.004). In women, the incidence of the primary endpoint was 24.14% in the LBBAP group and 36.2% in the BIVP group; however, this difference was not statistically significant (P = 0.23). Complication rates remained consistent across all groups. CONCLUSIONS: Men and women undergoing LBBAP for CRT had similar clinical outcomes. Men undergoing LBBAP showed a lower risk of heart failure-related hospitalizations and all-cause mortality compared to men undergoing BIVP, whereas there was no difference between LBBAP and BIVP in women.

13.
Arch Ital Urol Androl ; 96(2): 12703, 2024 Jun 27.
Artigo em Inglês | MEDLINE | ID: mdl-38934520

RESUMO

AIM: To present state of the art on the management of urinary stones from a panel of globally recognized urolithiasis experts who met during the Experts in Stone Disease Congress in Valencia in January 2024. Options of treatment: The surgical treatment modalities of renal and ureteral stones are well defined by the guidelines of international societies, although for some index cases more alternative options are possible. For 1.5 cm renal stones, both m-PCNL and RIRS have proven to be valid treatment alternatives with comparable stone-free rates. The m-PCNL has proven to be more cost effective and requires a shorter operative time, while the RIRS has demonstrated lower morbidity in terms of blood loss and shorter recovery times. SWL has proven to be less effective at least for lower calyceal stones but has the highest safety profile. For a 6mm obstructing stone of the pelviureteric junction (PUJ) stone, SWL should be the first choice for a stone less than 1 cm, due to less invasiveness and lower risk of complications although it has a lower stone free-rate. RIRS has advantages in certain conditions such as anticoagulant treatment, obesity, or body deformity. Technical issues of the surgical procedures for stone removal: In patients receiving antithrombotic therapy, SWL, PCN and open surgery are at elevated risk of hemorrhage or perinephric hematoma. URS, is associated with less morbidity in these cases. An individualized combined evaluation of risks of bleeding and thromboembolism should determine the perioperative thromboprophylactic strategy. Pre-interventional urine culture and antibiotic therapy are mandatory although UTI treatment is becoming more challenging due to increasing resistance to routinely applied antibiotics. The use of an intrarenal urine culture and stone culture is recommended to adapt antibiotic therapy in case of postoperative infectious complications. Measurements of temperature and pressure during RIRS are vital for ensuring patient safety and optimizing surgical outcomes although techniques of measurements and methods for data analysis are still to be refined. Ureteral stents were improved by the development of new biomaterials, new coatings, and new stent designs. Topics of current research are the development of drug eluting and bioresorbable stents. Complications of endoscopic treatment: PCNL is considered the most invasive surgical option. Fever and sepsis were observed in 11 and 0.5% and need for transfusion and embolization for bleeding in 7 and 0.4%. Major complications, as colonic, splenic, liver, gall bladder and bowel injuries are quite rare but are associated with significant morbidity. Ureteroscopy causes less complications, although some of them can be severe. They depend on high pressure in the urinary tract (sepsis or renal bleeding) or application of excessive force to the urinary tract (ureteral avulsion or stricture). Diagnostic work up:  Genetic testing consents the diagnosis of monogenetic conditions causing stones. It should be carried out in children and in selected adults. In adults, monogenetic diseases can be diagnosed by systematic genetic testing in no more than 4%, when cystinuria, APRT deficiency, and xanthinuria are excluded. A reliable stone analysis by infrared spectroscopy or X-ray diffraction is mandatory and should be associated to examination of the stone under a stereomicroscope. The analysis of digital images of stones by deep convolutional neural networks in dry laboratory or during endoscopic examination could allow the classification of stones based on their color and texture. Scanning electron microscopy (SEM) in association with energy dispersive spectrometry (EDS) is another fundamental research tool for the study of kidney stones. The combination of metagenomic analysis using Next Generation Sequencing (NGS) techniques and the enhanced quantitative urine culture (EQUC) protocol can be used to evaluate the urobiome of renal stone formers. Twenty-four hour urine analysis has a place during patient evaluation together with repeated measurements of urinary pH with a digital pH meter. Urinary supersaturation is the most comprehensive physicochemical risk factor employed in urolithiasis research. Urinary macromolecules can act as both promoters or inhibitors of stone formation depending on the chemical composition of urine in which they are operating. At the moment, there are no clinical applications of macromolecules in stone management or prophylaxis. Patients should be evaluated for the association with systemic pathologies. PROPHYLAXIS: Personalized medicine and public health interventions are complementary to prevent stone recurrence. Personalized medicine addresses a small part of stone patients with a high risk of recurrence and systemic complications requiring specific dietary and pharmacological treatment to prevent stone recurrence and complications of associated systemic diseases. The more numerous subjects who form one or a few stones during their entire lifespan should be treated by modifications of diet and lifestyle. Primary prevention by public health interventions is advisable to reduce prevalence of stones in the general population. Renal stone formers at "high-risk" for recurrence need early diagnosis to start specific treatment. Stone analysis allows the identification of most "high-risk" patients forming non-calcium stones: infection stones (struvite), uric acid and urates, cystine and other rare stones (dihydroxyadenine, xanthine). Patients at "high-risk" forming calcium stones require a more difficult diagnosis by clinical and laboratory evaluation. Particularly, patients with cystinuria and primary hyperoxaluria should be actively searched. FUTURE RESEARCH: Application of Artificial Intelligence are promising for automated identification of ureteral stones on CT imaging, prediction of stone composition and 24-hour urinary risk factors by demographics and clinical parameters, assessment of stone composition by evaluation of endoscopic images and prediction of outcomes of stone treatments. The synergy between urologists, nephrologists, and scientists in basic kidney stone research will enhance the depth and breadth of investigations, leading to a more comprehensive understanding of kidney stone formation.


Assuntos
Cálculos Urinários , Humanos , Cálculos Urinários/terapia , Cálculos Urinários/cirurgia , Previsões
14.
Vaccine ; 42(7): 1435-1439, 2024 Mar 07.
Artigo em Inglês | MEDLINE | ID: mdl-38336559

RESUMO

PURPOSE: To provide information about which pneumococcal vaccine could have greater coverage in Colombia. METHODS: This is a retrospective analysis of patients diagnosed with invasive pneumococcal disease (IPD) between 2015 and 2019 in Bogotá, Colombia. We compared the theoretical serotype coverage of the available anti-pneumococcal vaccines (i.e., PCV-10, PCV-10 SII, PCV-13, PCV-15, PCV-20, PCV-21, PCV24, PPSV-23) and the non-vaccine-covered serotypes stratified by age. RESULTS: 690 IPD cases were included. In children ≤5 y/o, of the approved vaccines PCV-20 showed the most theoretical protection (71.3 % [149/209]), while in adults aged 18-64 y/o was PCV-20 (61.8 % [164/265]), and in those ≥65 y/o was PPSV-23 (58.1 % [100/172]) followed by PCV-20 (55.2 % [95/172]). The non-covered serotypes represented one-third of the cohort (33.9 % [234/690]), being 6C (20.5 % [48/234]), 15A (12.8 % [30/234]), and 23A (11.5 % [27/234]) the most prevalent. CONCLUSION: Introducing PCV-20 for children and PCV-20 along with a PPSV-23 booster in adults may reduce IPD frequency in all ages in Colombia. The inclusion of non-covered serotypes is required for future vaccines.


Assuntos
Infecções Pneumocócicas , Streptococcus pneumoniae , Adulto , Criança , Humanos , Lactente , Colômbia/epidemiologia , Estudos Retrospectivos , Vacinação , Vacinas Conjugadas/uso terapêutico , Vacinas Pneumocócicas/uso terapêutico , Infecções Pneumocócicas/epidemiologia , Infecções Pneumocócicas/prevenção & controle , Sorogrupo
15.
Cir Cir ; 91(1): 87-93, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36787607

RESUMO

OBJECTIVE: To evaluate the preoperative tomographic characteristics of the nose and paranasal sinuses of children with chronic dacryocystitis. METHOD: Prospective, observational, cross-sectional, and descriptive study. CT scans of the paranasal sinuses of patients candidates for endoscopic dacryocystorhinostomy were evaluated for two years. Demographic characteristics, radiological findings, inflammatory processes and anatomical variants were identified using the Lund-Mackay classification. Statistic analysis. Stata 10.0, descriptive analysis, Student's t: mean difference and χ2. Logistic studies to estimate the probability between variables. RESULTS: 27 men and 11 women (n = 38) were included. Of these, 22 had unilateral and 16 bilateral nasolacrimal duct involvement. Lund-Mackay score range: 2-20. Eleven patients had associated pathology. The most affected were anterior and maxillary ethmoidal sinus (69%), osteomeatal complex (68%), posterior ethmoidal (51%). Patients with severe rhinosinusitis are 12 times more likely to develop dacryocystitis than patients with < 12 points. Men presented greater severity, affectation, and clinical repercussion. CONCLUSIONS: There is radiological rhinosinusal involvement in dacryocystitis, which must be evaluated and treated preoperatively to avoid postoperative complications or reinfections.


OBJETIVO: Evaluar las características tomográficas preoperatorias de la nariz y los senos paranasales de niños con dacriocistitis crónica. MÉTODO: Estudio prospectivo, observacional, transversal y descriptivo. Se evaluaron tomografías de senos paranasales de pacientes candidatos a dacriocistorrinostomía endoscópica, durante 2 años. Se identificaron características demográficas, hallazgos radiológicos, procesos inflamatorios y variantes anatómicas, utilizando la clasificación Lund-Mackay. Análisis estadístico con Stata 10.0, análisis descriptivo con t de Student: diferencia medias y χ2. Estudios logísticos para estimar la probabilidad entre variables. RESULTADOS: Se incluyeron 27 hombres y 11 mujeres (n = 38). De ellos, 22 tenían afección del conducto nasolagrimal unilateral y 16 bilateral. Rango de puntuación de Lund-Mackay: 2-20. Once pacientes tuvieron patología asociada. Seno etmoidal anterior y maxilar más afectados (69%), complejo osteomeatal (68%), etmoidal posterior (51%). La probabilidad de que los pacientes con rinosinusitis grave puedan presentar dacriocistitis es 12 veces mayor que en los pacientes con < 12 puntos. Los hombres presentaron mayor gravedad, afectación y repercusión clínica. CONCLUSIONES: Existe afección rinosinusal radiológica en la dacriocistitis, que debe ser evaluada y tratada en el preoperatorio para evitar complicaciones o reinfecciones posquirúrgicas.


Assuntos
Dacriocistite , Sinusite , Masculino , Criança , Humanos , Feminino , Estudos Prospectivos , Estudos Transversais , Sinusite/complicações , Sinusite/diagnóstico por imagem , Sinusite/cirurgia , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/cirurgia , Dacriocistite/diagnóstico por imagem , Dacriocistite/cirurgia , Doença Crônica
16.
Gels ; 9(11)2023 Nov 16.
Artigo em Inglês | MEDLINE | ID: mdl-37998999

RESUMO

This research explores the integration of DUT-67 metal organic frameworks into polyethyleneimine-based hydrogels to assemble a composite system with enough mechanical strength, pore structure and chemical affinity to work as a sorbent for water remediation. By varying the solvent-to-modulator ratio in a water-based synthesis path, the particle size of DUT-67 was successfully modulated from 1 µm to 200 nm. Once DUT-67 particles were integrated into the polymeric hydrogel, the composite hydrogel exhibited enhanced mechanical properties after the incorporation of the MOF filler. XPS, NMR, TGA, FTIR, and FT Raman studies confirmed the presence and interaction of the DUT-67 particles with the polymeric chains within the hydrogel network. Adsorption studies of methyl orange, copper(II) ions, and penicillin V on the composite hydrogel revealed a rapid adsorption kinetics and monolayer adsorption according to the Langmuir's model. The composite hydrogel demonstrated higher adsorption capacities, as compared to the pristine hydrogel, showcasing a synergistic effect, with maximum adsorption capacities of 473 ± 21 mg L-1, 86 ± 6 mg L-1, and 127 ± 4 mg L-1, for methyl orange, copper(II) ions, and penicillin V, respectively. This study highlights the potential of MOF-based composite hydrogels as efficient adsorbents for environmental pollutants and pharmaceuticals.

17.
J Colloid Interface Sci ; 623: 226-237, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35576652

RESUMO

S and N-doped carbon dots (S-CDs and N-CDs) and their cisplatin (cis-Pt) derivatives. (S-CDs@cis-Pt and N-CDs@cis-Pt) were tested on two ovarian cancer cell lines: A2780 and A2780 cells resistant to cis-Pt (A2780R). Several spectroscopic techniques were employed to check S-CDs@cis-Pt and N-CDs@cis-Pt: solid- and solution-state nuclear magnetic resonance, matrix-assisted laser desorption, ionization time-of-flight mass spectrometry, and X-ray photoelectron spectroscopy. In addition, synchrotron-based Fourier Transformed Infrared spectro-microscopy was used to evaluate the biochemical changes in cells after treatment with cis-Pt, S-CDs, N-CDs, or S-CDs@cis-Pt and N-CDs@cis-Pt, respectively. Computational chemistry was applied to establish the model for the most stable bond between S-CDs and N-CDs and cis-Pt. The results revealed the successful modification of S-CDs and N-CDs with cis-Pt and the formation of a stable composite system that can be used for drug delivery to cancer cells and likewise to overcome acquired cis-Pt resistance. Nanoparticle treatment of A2780 and A2780R cells led to the changes in their structure of lipids, proteins, and nucleic acids depending on the treatment. The results showed the S-CDs@cis-Pt and N-CDs@cis-Pt might be used in the combination with cis-Pt to treat the adenocarcinoma, thus having a potential to be further developed as drug delivery systems.


Assuntos
Adenocarcinoma , Neoplasias Ovarianas , Carbono , Linhagem Celular Tumoral , Cisplatino/química , Cisplatino/farmacologia , Feminino , Humanos , Neoplasias Ovarianas/metabolismo
18.
Chempluschem ; 87(7): e202200169, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35789218

RESUMO

This work describes the synthesis of 4-(4-AcPy) and 3-acetylpyridine (3-AcPy) copper soluble complexes for the activation of hydrogen peroxide and the concomitant generation of reactive oxygen species (ROS). Given the paramagnetic effects of copper ions in the Nuclear Magnetic Resonance (NMR) lines, we aimed at demonstrating that the combination of high-resolution 2D solid-state NMR experiments, Electron Paramagnetic Resonance (EPR), single-crystal X-ray crystallography and Density Functional Theory (DFT) calculations allows a detailed study of the chemical structure of the ligands and the surrounding metal ions. The copper complexes synthesized with CuCl2 were useful for the activation of H2 O2 during which the only ROS was the hydroxyl one, as demonstrated by EPR experiments. A removal of methyl orange (MO) azo-dye higher than 85 % was achieved in 200 minutes, combining 1.7 mM of copper complexes with 60 mM of H2 O2 and 40 µM of MO.


Assuntos
Cobre , Cobre/química , Cristalografia por Raios X , Espectroscopia de Ressonância de Spin Eletrônica , Ligantes , Espécies Reativas de Oxigênio
19.
Neurochem Res ; 36(4): 677-85, 2011 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-20978848

RESUMO

Cerebellar granule neurons (CGN) cultured in a 25 mM KCl medium (K25) die apoptotically when they are transferred to a medium containing 5 mM KCl (K5). It has been previously shown that apoptotic death of CGN induced by K5 is mediated by an increase in the levels of reactive oxygen species (ROS). ROS may participate in the apoptotic program either as signaling molecules or as effectors by causing oxidative damage to lipids, DNA and proteins. In this study we evaluated ROS production in CGN treated with K5 for different periods of time and evaluated a possible correlation between ROS production and oxidation of DNA proteins and two lipid peroxidation products, conjugated dienes and malondialdehyde. Under these conditions, we found two episodes of ROS generation, one at an early time (4 h) and another at a later time point (18-24 h). We also identified two peaks in the formation of conjugated dienes, the initial and transient by-products of lipoperoxidation. The first one occurred after 4 h of K5 treatment and the other was observed after 18 h, both of them correlated with the formation of ROS. In contrast, we found significant levels of the late product of lipidperoxidation, malondialdehyde only after 18 h of treatment. Besides, we did not find significant levels of DNA and protein oxidation products that could be correlated with the observed ROS production. These results support the idea that ROS produced early by K5 treatment could act primarily as a signal of the apoptotic cell death and that ROS produced later could be mainly a product of the cell death that could contribute directly to this process.


Assuntos
Apoptose , Cerebelo/metabolismo , Grânulos Citoplasmáticos/metabolismo , Neurônios/metabolismo , Potássio/metabolismo , Animais , Células Cultivadas , Cerebelo/citologia , DNA/metabolismo , Oxirredução , Espécies Reativas de Oxigênio/metabolismo , Substâncias Reativas com Ácido Tiobarbitúrico/metabolismo
20.
J Med Food ; 24(2): 111-115, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32397850

RESUMO

To evaluate the effect of berberine (BBR) plus bezafibrate administration on the lipid profile of patients with mixed dyslipidemia. A double-blind randomized pilot clinical trial with parallel groups was carried out in 36 patients, aged 30-60 years with mixed dyslipidemia [triglycerides (TG) ≥1.7 mM and total cholesterol (TC) ≥5.2 mM]. Patients were assigned to 3 groups of 12 patients each, receiving oral administration during 90 days of BBR 500 mg t.i.d., bezafibrate 400 mg b.i.d., or BBR 500 mg t.i.d. plus bezafibrate 400 mg b.i.d, respectively. Clinical evaluation, lipid profile, glucose, creatinine, and uric acid levels were measured before and after the pharmacological intervention. Kruskal-Wallis, Wilcoxon, Mann-Whitney U, and χ2 tests were used for statistical analyses; a P ≤ .05 was considered statistically significant. BBR reduced TC levels. Bezafibrate decreased TG, TC, low-density lipoprotein cholesterol (LDL-C), and very low-density lipoprotein (VLDL) concentrations. BBR plus bezafibrate decreased TG (2.6 ± 0.8 vs. 1.3 ± 0.7 mM, P = .007), TC (6.3 ± 0.7 vs. 4.6 ± 1.2 mM, P = .005), LDL-C (3.4 ± 0.6 vs. 2.2 ± 1.3 mM, P = .037), and VLDL (0.5 ± 0.2 vs. 0.2 ± 0.1 mM, P = .007) levels. Bezafibrate and BBR plus bezafibrate significantly decreased TG, TC, LDL-C, and VLDL concentrations, and thus, remitting the diagnosis of mixed dyslipidemia in 90% of the patients.


Assuntos
Berberina/administração & dosagem , Bezafibrato , Dislipidemias , Adulto , Bezafibrato/administração & dosagem , Dislipidemias/tratamento farmacológico , Humanos , Lipídeos/sangue , Pessoa de Meia-Idade , Projetos Piloto , Triglicerídeos/sangue
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