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1.
Occup Med (Lond) ; 72(6): 394-402, 2022 08 16.
Artículo en Inglés | MEDLINE | ID: mdl-35639982

RESUMEN

BACKGROUND: Uncontrolled occupational exposure to silica is still frequent in Brazil, with several recent records in the state of Minas Gerais. However, few national studies have addressed silica-related diseases other than silicosis. AIMS: To describe the occurrence of the main non-malignant silica-related diseases: silicosis, tuberculosis (TB), chronic obstructive pulmonary disease (COPD), and autoimmune diseases in a specialized outpatient clinic. METHODS: Case series study of 1525 patients exposed to silica, seen between 1984 and 2021, with descriptive findings of clinical and occupational data from the first medical evaluation. RESULTS: Medians of age and exposure time were 47 and 15 years, respectively, and 97% of patients were male. The prevalence of silicosis was 44%, of which 27% had large opacities. The main occupational sectors were underground gold mining (28%), precious and semi-precious stone work (20%), and artisanal mining (9%). Spirometries were abnormal in 55%, with obstructive disorder being the most common finding. COPD (25%), active TB or sequelae (12%), and connective tissue diseases (6%) were diagnosed in patients with and without silicosis. CONCLUSIONS: The percentage of silicosis appears to be alarming, even considering the biases of selective referrals. The patients were relatively young and already had a functional impact, caused not only by silicosis but by one or more silica-related diseases. COPD, TB, and connective tissue diseases proved to be frequent, leading to the need for specifics protocols to investigate them in individuals exposed to silica. By adopting strategies to combat silicosis, the prevention of other silica-related diseases is concomitantly promoted.


Asunto(s)
Exposición Profesional , Enfermedad Pulmonar Obstructiva Crónica , Silicosis , Tuberculosis , Instituciones de Atención Ambulatoria , Femenino , Humanos , Masculino , Exposición Profesional/prevención & control , Enfermedad Pulmonar Obstructiva Crónica/complicaciones , Enfermedad Pulmonar Obstructiva Crónica/etiología , Dióxido de Silicio/efectos adversos , Dióxido de Silicio/análisis , Silicosis/diagnóstico , Silicosis/epidemiología , Silicosis/etiología
2.
Microbiology (Reading) ; 167(12)2021 12.
Artículo en Inglés | MEDLINE | ID: mdl-34914577

RESUMEN

Members of Shewanella are ubiquitous in aquatic environments, some of which have been implicated in human infections. The progenitors of antibiotic resistance genes with clinical relevance, such as qnrA genes, have been identified in Shewanella. qnrA code for a pentapeptide repeat protein that protects type II topoisomerases, decreasing susceptibility to quinolones and fluoroquinolones. In this study, 248 genomes of 49 Shewanella species were analysed as well as 33 environmental isolates belonging to 10 Shewanella species. The presence of the qnrA gene was detected in 22.9% of the genomes and 15.2% of the isolates. The gene was more often detected in Shewanella algae, but was also detected in Shewanella carassii, Shewanella chilikensis, Shewanella haliotis and Shewanella indica. The identified genes encoded the previously described variants QnrA3 (in 22 genomes of one species), QnrA2 (eight genomes and three species), QnrA1 (six genomes and two species), QnrA7 (five genomes and two species), QnrA10 (two genomes of one species) and QnrA4 (one genome). In addition, 11 novel variants with 3 to 7 amino acid substitutions were identified (in 13 genomes and one environmental isolate). The presence of this gene appears to be species-specific although within some species several variants were detected. The study presents a previously unknown diversity of qnrA in Shewanella, highlighting the role of this genus as progenitor and reservoir of these genes. Further studies are needed to determine the phenotypes conferred by the new variants and the mechanisms that may mediate the transfer of these genes to new hosts.


Asunto(s)
Quinolonas , Shewanella , Antibacterianos/farmacología , Farmacorresistencia Bacteriana/genética , Shewanella/genética
3.
Oral Dis ; 24(6): 1073-1082, 2018 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-29480944

RESUMEN

OBJECTIVE: To investigate the effect of sildenafil citrate on the prevention and progression of experimental periodontitis (EP) in rats. MATERIALS AND METHODS: Thirty-six male Wistar rats were randomly assigned into two groups: Group 1 (preventive) and Group 2 (progression). In Group 1, the animals received daily doses of sildenafil (10 mg/kg) or vehicle for 30 days, and EP was induced on the 15th day. In Group 2, the EP was induced on the first day, and the animals received daily doses of sildenafil (10 mg/kg) or vehicle from the 15th day. For EP, ligatures were placed around the right first mandibular molars. Microtomographic, histomorphometric and histological analyses were carried out to evaluate the alveolar bone loss and inflammatory degree. For statistical analyses, t test and the Mann-Whitney test were used, considering a level of significance of 95%. RESULTS: In Group 2, the animals treated with sildenafil showed a significantly lower bone resorption (p = .05). Similarly, the subgroup treated with sildenafil displayed a significantly lesser degree of inflammation (p = .01). No significant differences were observed between the subgroups of the Group 1. CONCLUSIONS: Sildenafil decreased the inflammatory process, as well as the alveolar bone loss when used to modulate the progression of experimental periodontitis.


Asunto(s)
Periodontitis/tratamiento farmacológico , Periodontitis/prevención & control , Inhibidores de Fosfodiesterasa 5/uso terapéutico , Citrato de Sildenafil/uso terapéutico , Animales , Resorción Ósea/prevención & control , Masculino , Periodontitis/diagnóstico por imagen , Periodontitis/patología , Distribución Aleatoria , Ratas , Microtomografía por Rayos X
4.
Colorectal Dis ; 19(6): O196-O203, 2017 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-28436197

RESUMEN

AIM: Full-thickness local excision after neoadjuvant chemoradiotherapy (CRT) for patients with rectal cancer and incomplete clinical response has been a treatment strategy for organ preservation. Follow-up of these patients is challenging since anatomic distortion and postoperative changes may be clinically indistinguishable from tumour recurrence. MRI may have a role in detecting recurrence. The aim of this study was to describe the MRI findings during follow-up in patients having local excision following CRT with and without local recurrence. METHOD: The data were collected retrospectively from a single centre. Fifty-three patients with rectal cancer who had full-thickness local excision after neoadjuvant CRT and near-complete response were eligible for the study. Patients with local recurrence were treated by radical salvage surgery. The main outcome was local MRI assessment findings during follow-up. RESULTS: Fifteen patients (five who developed local recurrence and 10 with no evidence of local recurrence) had MR images available for review and were included in the study. High signal intensity and thickening of the rectal wall were present in all patients with recurrent disease within the rectal wall. Overall, 80% of the patients with recurrence showed diffusion restriction. MRI mesorectal fascia status and circumferential resection margin showed agreement in all cases. A low signal intensity scar was seen in all patients without recurrent disease. CONCLUSION: MRI shows high signal intensity and thickening of the rectal wall in recurrent disease in comparison to a low signal intensity fibrotic scar in non-recurrent disease. These findings may be useful in surveillance of these patients.


Asunto(s)
Quimioradioterapia Adyuvante/métodos , Imagen por Resonancia Magnética , Recurrencia Local de Neoplasia/diagnóstico por imagen , Neoplasias del Recto/diagnóstico por imagen , Microcirugía Endoscópica Transanal/métodos , Anciano , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Terapia Neoadyuvante/métodos , Recurrencia Local de Neoplasia/patología , Recurrencia Local de Neoplasia/cirugía , Estadificación de Neoplasias , Periodo Posoperatorio , Neoplasias del Recto/patología , Neoplasias del Recto/terapia , Recto/diagnóstico por imagen , Recto/cirugía , Estudios Retrospectivos , Terapia Recuperativa , Resultado del Tratamiento
5.
Colorectal Dis ; 18(3): 247-54, 2016 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-26299511

RESUMEN

AIM: The correct analysis of lymph node status is one of the most important parameters for the accurate pathological diagnosis of colorectal cancer. Our aim was to evaluate the number of lymph nodes among the specimens obtained from colorectal resections due to colorectal cancer, before and after the routine use of a lymph node revealing solution (LNRS). METHOD: Data from 780 surgical specimens from patients of both genders with colorectal cancer were studied. The cases were divided chronologically into two groups: the conventional group included 497 specimens treated with conventional methods, i.e. without the use of the LNRS (January 2000 to July 2007), and the LNRS group included 283 specimens examined through the routine use of this solution (August 2007 to July 2012). RESULTS: Most patients were female (57.4%) with a median age of 62 years. The median lymph node number was 18, and 75.9% of the cases (592) had 12 or more nodes dissected. Lymph node metastases were noted in 334 cases (42.8%). A median of 24 lymph nodes was dissected in the LNRS group compared to 15 in the conventional group (P < 0.001). The LNRS group had 9.2% of cases with fewer than 12 lymph nodes dissected compared with 32.6% in the conventional group (P < 0.001). CONCLUSIONS: The use of the LNRS increases the number of lymph nodes obtained from colorectal cancer surgical specimens and can help to reduce the number of cases with < 12 lymph nodes.


Asunto(s)
Ácido Acético/uso terapéutico , Neoplasias Colorrectales/patología , Etanol/uso terapéutico , Éter/uso terapéutico , Formaldehído/uso terapéutico , Indicadores y Reactivos , Ganglios Linfáticos/patología , Biopsia del Ganglio Linfático Centinela/métodos , Coloración y Etiquetado/métodos , Adenocarcinoma/patología , Adenocarcinoma/cirugía , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Colectomía/métodos , Neoplasias Colorrectales/cirugía , Femenino , Humanos , Indicadores y Reactivos/química , Ganglios Linfáticos/cirugía , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Estudios Retrospectivos , Adulto Joven
6.
Genet Mol Res ; 15(1)2016 Feb 05.
Artículo en Inglés | MEDLINE | ID: mdl-26909961

RESUMEN

Jatropha gossypiifolia L. (Euphorbiaceae) is widely used in popular medicine. However, further toxicological studies are necessary for its reliable use. The present study aimed to evaluate the cytotoxic, genotoxic, and mutagenic effects of ethanolic and aqueous leaf extracts of J. gossypiifolia, using the test system Allium cepa. In addition, the phytochemical profile of the extracts was also obtained. Seeds of A. cepa were subjected to different concentrations of the two extracts (0.001, 0.01, 0.1, 1, and 10 mg/mL). Distilled water was used for the negative control and methyl methanesulfonate (4 x 10(-4) M) and trifluralin (0.84 ppm) for the positive controls. The values of mitotic index at all concentrations of ethanolic extract and at 0.1, 1, and 10 mg/mL aqueous extract showed a significant decrease. Alterations, such as chromosome adherence, C-metaphases, chromosome bridges, nuclear buds, and micronuclei were verified in both extracts but chromosome loss indicating genotoxic activity was observed only in the ethanolic extract. Presence of micronuclei on administration of the extracts, also indicated mutagenic action at the chromosome level. In the ethanolic extract, aneugenicity seemed to be the main activity, probably as a result of the action of terpenes and/or flavonoids, whereas in the aqueous extract, clastogenic action appeared to be the principal activity, presumably as a consequence of the effect of flavonoids and/or saponins. Thus, we suggest that the extracts of this species should be used with great caution for medicinal purpose.


Asunto(s)
Aberraciones Cromosómicas/inducido químicamente , Jatropha/efectos adversos , Cebollas/efectos de los fármacos , Extractos Vegetales/efectos adversos , Hojas de la Planta/química , Flavonoides , Jatropha/química , Jatropha/toxicidad , Índice Mitótico , Cebollas/genética , Extractos Vegetales/química , Extractos Vegetales/toxicidad , Saponinas , Semillas/efectos de los fármacos , Semillas/genética
9.
Enferm Intensiva ; 27(2): 75-80, 2016.
Artículo en Español | MEDLINE | ID: mdl-27137415

RESUMEN

An individualised care plan is described for a woman diagnosed with pneumonia, intubated, and on invasive mechanical ventilation, who was admitted to the Intensive Care Unit for extracorporeal membrane oxygenation (ECMO). A nursing care plan was designed based on Marjory Gordon functional patterns. The most important nursing diagnoses were prioritised, using a model of clinical reasoning model (Analysis of the current status) and NANDA taxonomy. A description is presented on, death anxiety, impaired gas exchange, decreased cardiac output, dysfunctional gastrointestinal motility, risk for disuse syndrome, infection risk, and bleeding risk. The principal objectives were: to reduce the fear of the family, achieve optimal respiratory and cardiovascular status, to maintain gastrointestinal function, to avoid immobility complications, and to reduce the risk of infection and bleeding. As regards activities performed: we gave family support; correct management of the mechanical ventilation airway, cardio-respiratory monitoring, skin and nutritional status; control of possible infections and bleeding (management of therapies, care of catheters…). A Likert's scale was used to evaluate the results, accomplishing all key performance indicators which were propose at the beginning. Individualised care plans with NNN taxonomy using the veno-venous ECMO have not been described. Other ECMO care plans have not used the same analysis model. This case can help nurses to take care of patients subjected to veno-venous ECMO treatment, although more cases are needed to standardise nursing care using NANDA taxonomy.


Asunto(s)
Oxigenación por Membrana Extracorpórea , Anciano , Oxigenación por Membrana Extracorpórea/métodos , Femenino , Humanos , Neumonía/terapia , Medicina de Precisión , Respiración Artificial
10.
Br J Surg ; 102(5): 558-62, 2015 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-25692968

RESUMEN

BACKGROUND: Although anorectal transplantation is a challenging procedure, it is a promising option for patients who have completely lost anorectal function or in whom it failed to develop, as in congenital malformations. The paucity of animal models with which to test functional outcomes was addressed in this study of anorectal manometry in rats. METHODS: Wistar rats were assigned randomly to four groups: orthotopic anorectal transplantation, heterotopic transplantation, sham operation, or normal control. Bodyweight and anal pressure were measured immediately before and after operation, and on postoperative days 7 and 14. ANOVA and Tukey's test were used to compare results for bodyweight, anal manometry and length of procedure. RESULTS: Immediately after the procedure, mean(s.d.) anal pressure in the orthotopic group (n = 13) dropped from 31·4(13·1) to 1·6(13·1) cmH2 O (P < 0·001 versus both sham operation (n = 13) and normal control (n = 15)), with partial recovery on postoperative day 7 (14·9(13·9) cmH2 O) (P = 0·009 versus normal control) and complete recovery on day 14 (23·7(12·2) cmH2 O). Heterotopic rats (n = 14) demonstrated partial functional recovery: mean(s.d.) anal pressure was 26·9(10·9) cmH2 O before operation and 8·6(6·8) cmH2 O on postoperative day 14 (P < 0·001 versus both sham and normal control). CONCLUSION: Orthotopic anorectal transplantation may result in better functional outcomes than heterotopic procedures. Surgical relevance Patients with a permanent colostomy have limited continence. Treatment options are available, but anorectal transplantation may offer hope. Some experimental studies have been conducted, but available data are currently insufficient to translate into a clinical option. This paper details functional outcomes in a rat model of anorectal autotransplantation. It represents a step in the translational research that may lead to restoration of anorectal function in patients who have lost or have failed to develop it.


Asunto(s)
Canal Anal/trasplante , Recto/trasplante , Canal Anal/fisiología , Análisis de Varianza , Animales , Masculino , Manometría , Modelos Animales , Tempo Operativo , Presión , Distribución Aleatoria , Ratas Wistar , Recto/fisiología , Trasplante Autólogo
11.
Plant Cell Rep ; 34(8): 1281-93, 2015 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-25812837

RESUMEN

Priming applied to commercial seed lots is widely used by seed technologists to enhance seed vigour in terms of germination potential and increased stress tolerance. Priming can be also valuable to seed bank operators who need improved protocols of ex situ conservation of germplasm collections (crop and native species). Depending on plant species, seed morphology and physiology, different priming treatments can be applied, all of them triggering the so-called 'pre-germinative metabolism'. This physiological process takes place during early seed imbibition and includes the seed repair response (activation of DNA repair pathways and antioxidant mechanisms), essential to preserve genome integrity, ensuring proper germination and seedling development. The review provides an overview of priming technology, describing the range of physical-chemical and biological treatments currently available. Optimised priming protocols can be designed using the 'hydrotime concept' analysis which provides the theoretical bases for assessing the relationship between water potential and germination rate. Despite the efforts so far reported to further improve seed priming, novel ideas and cutting-edge investigations need to be brought into this technological sector of agri-seed industry. Multidisciplinary translational research combining digital, bioinformatic and molecular tools will significantly contribute to expand the range of priming applications to other relevant commercial sectors, e.g. the native seed market.


Asunto(s)
Germinación/fisiología , Semillas/fisiología , Producción de Cultivos/métodos , Latencia en las Plantas/fisiología , Banco de Semillas , Semillas/crecimiento & desarrollo , Semillas/metabolismo , Agua/metabolismo
12.
Tech Coloproctol ; 19(2): 69-82, 2015 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-25380741

RESUMEN

Achieving a clear distal or circumferential resection margins with laparoscopic total mesorectal excision (TME) may be laborious, especially in obese males and when operating on advanced distal rectal tumors with a poor response to neoadjuvant treatment. Transanal (TaTME) is a new natural orifice translumenal endoscopic surgery modality in which the rectum is mobilized transanally using endoscopic techniques with or without laparoscopic assistance. We conducted a comprehensive systematic review of publications on this new technique in PubMed and Embase databases from January, 2008, to July, 2014. Experimental and clinical studies written in English were included. Experimental research with TaTME was done on pigs with and without survival models and on human cadavers. In these studies, laparoscopic or transgastric assistance was frequently used resulting in an easier upper rectal dissection and in a longer rectal specimen. To date, 150 patients in 16 clinical studies have undergone TaTME. In all but 15 cases, transabdominal assistance was used. A rigid transanal endoscopic operations/transanal endoscopic microsurgery (TEO/TEM) platform was used in 37 patients. Rectal adenocarcinoma was the indication in all except for nine cases of benign diseases. Operative times ranged from 90 to 460 min. TME quality was deemed intact, satisfactory, or complete. Involvement in circumferential resection margins was detected in 16 (11.8 %) patients. The mean lymph node harvest was equal or greater than 12 in all studies. Regarding morbidity, pneumoretroperitoneum, damage to the urethra, and air embolism were reported intraoperatively. Mean hospital stay varied from 4 to 14 days. Postoperative complications occurred in 34 (22.7 %) patients. TaTME with TEM is feasible in selected cases. Oncologic safety parameters seem to be adequate although the evidence relies on small retrospective series conducted by highly trained surgeons. Further studies are expected.


Asunto(s)
Canal Anal , Endoscopía Gastrointestinal/métodos , Cirugía Endoscópica por Orificios Naturales/métodos , Neoplasias del Recto/cirugía , Recto/cirugía , Animales , Cadáver , Humanos , Laparoscopía/métodos , Microcirugia , Procedimientos Quirúrgicos Robotizados , Porcinos
13.
J Helminthol ; 89(4): 428-32, 2015 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-24725417

RESUMEN

This study investigated the epidemiological factors that contribute to the seroprevalence of Toxoplasma gondii and Toxocara spp. in children from Paraná state, Brazil. Immunoglobulin G (IgG) antibodies to T. gondii were detected using indirect immunofluorescence, and IgG antibodies to Toxocara were detected using an enzyme-linked immunosorbent assay. For each individual, a questionnaire was completed that contained epidemiological and clinical data. The data analysis was performed using multiple logistic regression. Of the 544 children investigated, 3.2% presented co-infection with T. gondii and Toxocara spp. Of this total, 7.4% were positive for antibodies to T. gondii, and 25% were positive for antibodies to Toxocara spp. The presence of antibodies to Toxocara spp. increased the risk of T. gondii infection (P = 0.029). Children who were 1-8 years of age were less infected by T. gondii than those who were 9-12 years of age. The variables that influenced positivity for anti-Toxocara spp. were the origin of the children and contact with sand. Children with positive serology for Toxocara spp. presented more eosinophilia compared with those with non-reactive serology. Infection with both parasites reveals the need for preventive measures, such as guidance about modes of infection, parasite control and monitoring recreational areas.


Asunto(s)
Toxocariasis/epidemiología , Toxoplasmosis/epidemiología , Animales , Anticuerpos Antiprotozoarios/sangre , Brasil/epidemiología , Niño , Preescolar , Femenino , Humanos , Inmunoglobulina G/sangre , Lactante , Modelos Logísticos , Masculino , Factores de Riesgo , Toxocara/inmunología , Toxoplasma/inmunología , Toxoplasmosis/sangre
14.
ESMO Open ; 8(1): 100771, 2023 02.
Artículo en Inglés | MEDLINE | ID: mdl-36638709

RESUMEN

BACKGROUND: Neoadjuvant chemotherapy may improve overall survival (OS) in 'borderline' resectable pancreatic cancer (RPC). Whether the results are the same in upfront RPC is unknown. MATERIALS AND METHODS: To evaluate the association of neoadjuvant treatment and survival outcomes in RPC, a systematic literature review was carried out including prospective randomized trials of neoadjuvant treatment versus upfront surgery. Articles indexed in PubMed, Embase and Scopus were evaluated. Data regarding systemic treatment regimens, R0 resection rates, disease-free survival (DFS) and OS were extracted. The outcomes were compared using a random-effects model. The index I2 and the graphs of funnel plot were used for the interpretation of the data. RESULTS: Of 3229 abstracts, 6 randomized controlled trials were considered eligible with a combined sample size of 805 RPC patients. Among the trials, PACT-15, PREP-02/JSAP-05 and updated long-term results from PREOPANC and NEONAX trials were included. Combining the studies with meta-analysis, we could see that neoadjuvant treatment in RPC does not improve DFS [hazard ratio (HR) 0.71 (0.46-1.09)] or OS [HR 0.76 (0.52-1.11)], without significant heterogeneity. Interestingly, R0 rates improved ∼20% with the neoadjuvant approach [HR 1.2 (1.04-1.37)]. It is important to note that most studies evaluated gemcitabine-based regimens in the neoadjuvant setting. CONCLUSIONS: Neoadjuvant chemotherapy or chemoradiation does not improve DFS or OS in RPC compared to upfront surgery followed by adjuvant treatment. Neoadjuvant treatment improves R0 rates by ∼20%. Randomized ongoing trials are eagerly awaited with more active combined regimens including modified FOLFIRINOX.


Asunto(s)
Neoplasias Pancreáticas , Humanos , Neoplasias Pancreáticas/tratamiento farmacológico , Terapia Neoadyuvante/métodos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Estudios Prospectivos , Ensayos Clínicos Controlados Aleatorios como Asunto , Neoplasias Pancreáticas
15.
Hernia ; 27(3): 519-526, 2023 06.
Artículo en Inglés | MEDLINE | ID: mdl-37069319

RESUMEN

PURPOSE: Drain placement in retromuscular ventral hernia repair is controversial. Although it may reduce seroma formation, there is a concern regarding an increase in infectious complications. We aimed to perform a meta-analysis on retromuscular drain placement in retromuscular ventral hernia repair. METHODS: We performed a literature search of Cochrane, Scopus and PubMed databases to identify studies comparing drain placement and the absence of drain in patients undergoing retromuscular ventral hernia repair. Postoperative outcomes were assessed by pooled analysis and meta-analysis. Statistical analysis was performed using RevMan 5.4. Heterogeneity was assessed with I2 statistics. RESULTS: 3808 studies were screened and 48 were thoroughly reviewed. Four studies comprising 1724 patients were included in the analysis. We found that drain placement was significantly associated with a decrease in seroma (OR 0.34; 95% CI 0.12-0.96; P = 0.04; I2 = 78%). Moreover, no differences were noted in surgical site infection, hematoma, surgical site occurrences or surgical site occurrences requiring procedural intervention. CONCLUSIONS: Based on the analysis of short-term outcomes, retromuscular drain placement after retromuscular ventral hernia repair significantly reduces seroma and does not increase infectious complications. Further prospective randomized studies are necessary to confirm our findings, evaluate the optimal duration of drain placement, and report longer-term outcomes.


Asunto(s)
Hernia Ventral , Hernia Incisional , Humanos , Seroma/etiología , Herniorrafia/efectos adversos , Hernia Ventral/cirugía , Hernia Ventral/complicaciones , Infección de la Herida Quirúrgica/etiología , Infección de la Herida Quirúrgica/cirugía , Drenaje , Mallas Quirúrgicas/efectos adversos , Hernia Incisional/cirugía
16.
J Clin Pharm Ther ; 37(4): 420-5, 2012 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-22017324

RESUMEN

WHAT IS KNOWN AND OBJECTIVE: Some antimicrobial agents are active in vitro against Leptospiras. The use of penicillins at the late stage of leptospirosis is still controversial. We aimed to evaluate the use of penicillin in patients with leptospirosis-associated acute kidney injury (AKI). METHODS: A retrospective study was conducted of patients with leptospirosis admitted to two hospitals in Fortaleza city, Brazil, between 1985 and 2008. AKI was defined according to the RIFLE and AKIN classifications. Patients were divided in two groups according to whether they were treated with a penicillin or not. RESULTS: Two hundred and eighty-seven patients were included, with an average age of 36·8±15·6 years and mostly male (80·8%). One hundred and twelve patients (39%) received a penicillin. Patients treated with a penicillin were younger (32±14 years vs. 39±16 years, P=0·0002) and had a shorter hospital stay (8·4±5·0 vs. 11±7·7 days, P<0·0001). There was no difference in the onset of symptoms before hospital admission between the two groups (6·5±3·0 vs. 7·7±4·7, P=0·33). Systolic blood pressure was lower in the penicillin group (111±21 vs. 119±22 mmHg, P=0·04). AKI, need of dialysis and renal recovery at the time of hospital discharge were more frequent in patients who did not use a penicillin (P<0·05). Mortality was similar in both groups (11·6% vs. 13·7%, P=0·60). CONCLUSION: Treatment of leptospirosis with antibiotics, including the penicillin, remains controversial. The main benefit of using penicillin in the present study was a reduction in the length of hospital stay and fewer complications, such as AKI, but its use was not associated with a decrease in mortality. On balance of risks and benefits, we recommend the use of penicillin in late-stage leptospirosis.


Asunto(s)
Lesión Renal Aguda/tratamiento farmacológico , Leptospirosis/tratamiento farmacológico , Penicilinas/uso terapéutico , Lesión Renal Aguda/microbiología , Lesión Renal Aguda/mortalidad , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Brasil , Niño , Femenino , Humanos , Tiempo de Internación , Leptospirosis/complicaciones , Leptospirosis/mortalidad , Masculino , Persona de Mediana Edad , Penicilinas/administración & dosificación , Estudios Retrospectivos , Factores de Tiempo , Adulto Joven
17.
Toxicol In Vitro ; 83: 105404, 2022 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-35654257

RESUMEN

The toxicity of diphenyl ditelluride (PhTe)2 is associated with its ability to oxidize sulfhydryl groups from biological molecules. Therefore, we evaluated possible molecular mechanisms of toxicity induced by this organochalcogen in Escherichia coli (E. coli) by evaluating oxidative damage markers, relative expression of genes associated with the cellular redox state in bacteria, such as katG, sodA, sodB, soxS, and oxyR, as well as the activity of enzymes responsible for cellular redox balance. After exposure of (PhTe)2 (6, 12, and 24 µg/mL), there was a decrease in non-protein thiols (NPSH) levels, an increase in protein carbonylation and lipid peroxidation in E. coli. Intra- and extracellular reactive species (RS) was increased at concentrations of 6, 12, and 24 µg/mL. The superoxide dismutase (SOD) activity was increased at the three concentrations tested, while catalase (CAT) activity was higher at 12 and 24 µg/mL. The soxS gene showed lower expression at the three concentrations tested, while the oxyR gene was supressed at 24 µg/mL. The katG antioxidant response gene showed lower expression, and sodA and sodB were positively activated, except for sodB at 6 µg/mL. Our findings demonstrate that exposure to (PhTe)2 induced RS formation, NPSH depletion and changes in transcriptional factors regulation, characterizing it as a multi-target compound, causing disruption in cellular oxidative state, as well as molecular mechanisms associated in E. coli.


Asunto(s)
Escherichia coli , Superóxido Dismutasa , Antioxidantes/metabolismo , Antioxidantes/farmacología , Derivados del Benceno , Catalasa/genética , Catalasa/metabolismo , Escherichia coli/genética , Escherichia coli/metabolismo , Compuestos Organometálicos , Oxidación-Reducción , Estrés Oxidativo , Compuestos de Sulfhidrilo/metabolismo , Superóxido Dismutasa/metabolismo , Superóxido Dismutasa-1/metabolismo
18.
Colorectal Dis ; 13(3): 317-22, 2011 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-19906053

RESUMEN

AIM: Chagas' disease is an endemic parasitosis found in Latin America. The disease affects different organs, such as heart, oesophagus, colon and rectum. Megacolon is the most frequent long-term complication, caused by damage to the myoenteric and submucous plexus, ultimately leading to a functional barrier to the faeces. Patients with severe constipation are managed surgically. The study aimed to analyse the 10-year minimum functional outcome after rectosigmoidectomy with posterior end-to-side anastomosis (RPESA). METHOD: A total of 21 of 46 patients were available for follow up. Patients underwent clinical, radiological and manometric evaluation, and the results were compared with preoperative parameters. RESULTS: Of the 21 patients evaluated, 81% (17) were female, with a mean age of 60.6 years. Good function was achieved in all patients, with significant improvement in defaecatory frequency (P < 0.0001), usage of enemas (P < 0.0001) and patient satisfaction. Barium enema also showed resolution of the colonic and rectal dilatation in 19 cases evaluated postoperatively. CONCLUSION: Minimal 10-year follow up of RPESA showed excellent functional results, with no recurrence of constipation.


Asunto(s)
Enfermedad de Chagas/complicaciones , Colon Sigmoide/cirugía , Procedimientos Quirúrgicos del Sistema Digestivo/métodos , Megacolon/cirugía , Recto/cirugía , Adulto , Anciano , Canal Anal/fisiología , Anastomosis Quirúrgica/efectos adversos , Anastomosis Quirúrgica/métodos , Colon/anatomía & histología , Colon/diagnóstico por imagen , Estreñimiento/cirugía , Defecación , Femenino , Estudios de Seguimiento , Humanos , Laxativos/uso terapéutico , Masculino , Manometría , Megacolon/etiología , Megacolon/parasitología , Persona de Mediana Edad , Radiografía , Factores de Tiempo , Resultado del Tratamiento , Adulto Joven
19.
Braz J Med Biol Res ; 54(4): e9369, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33681893

RESUMEN

Tacrolimus (TAC), a calcineurin inhibitor, and everolimus (EVL), an mTOR inhibitor, have been used as immunosuppressive (ISS) drugs in post-kidney transplantation therapy. The objective of this study was to compare the efficacy of EVL vs TAC in the ISS maintenance triple therapy. Ninety-seven kidney transplant patients, who received triple maintenance therapy with TAC, mycophenolate mofetil (MMF), and methyl prednisone (PRED), were evaluated. After four months of post-kidney transplant therapy, 30 patients enrolled in a randomized controlled clinical trial, in which 16 patients received TAC+MMF+PRED (cohort 1), and 14 patients switched to EVL+MMF+PRED (cohort 2). The patients were followed-up for 36 months. Two patients from cohort 1 lost their grafts after one year due to non-adherence. Two patients from cohort 2 had intolerance to mTOR inhibitors and were switched back to TAC from EVL. One case (6.25%) in cohort 1 and three cases (21.43%) in cohort 2 of acute T-cell-mediated rejection was observed. Antibody-mediated acute rejection (ABMAR) was observed in four patients (25.0%) in cohort 1, and antibody-mediated chronic rejection (ABMCR) was observed in two patients (12.50%). One patient from cohort 2 lost the graft after 15 months due to polyomavirus infection. The graft survival rate was 87.50% in cohort 1 and 92.86% in cohort 2. This clinical trial showed that the EVL+MMF+PRED triple maintenance therapy was efficacious compared with TAC during 32 months of follow-up. However, further studies are needed to confirm the efficacy of this regimen for long-term graft survival.


Asunto(s)
Trasplante de Riñón , Tacrolimus , Quimioterapia Combinada , Everolimus/uso terapéutico , Rechazo de Injerto/prevención & control , Supervivencia de Injerto , Humanos , Inmunosupresores/uso terapéutico , Tacrolimus/uso terapéutico
20.
Artículo en Inglés | MEDLINE | ID: mdl-32850771

RESUMEN

The waste produced by petrochemical industries has a significant environmental impact. Biotechnological approaches offer promising alternatives for waste treatment in a sustainable and environment-friendly manner. Microbial consortia potentially clean up the wastes through degradation of hydrocarbons using biosurfactants as adjuvants. In this work, microbial consortia were obtained from a production water (PW) sample from a Brazilian oil reservoir using enrichment and selection approaches in the presence of oil as carbon source. A consortium was obtained using Bushnell-Haas (BH) mineral medium with petroleum. In parallel, another consortium was obtained in yeast extract peptone dextrose (YPD)-rich medium and was subsequently compared to the BH mineral medium with petroleum. Metagenomic sequencing of these microbial communities showed that the BH consortium was less diverse and predominantly composed of Brevibacillus genus members, while the YPD consortium was taxonomically more diverse. Functional annotation revealed that the BH consortium was enriched with genes involved in biosurfactant synthesis, while the YPD consortium presented higher abundance of hydrocarbon degradation genes. The comparison of these two consortia against consortia available in public databases confirmed the enrichment of biosurfactant genes in the BH consortium. Functional assays showed that the BH consortium exhibits high cellular hydrophobicity and formation of stable emulsions, suggesting that oil uptake by microorganisms might be favored by biosurfactants. In contrast, the YPD consortium was more efficient than the BH consortium in reducing interfacial tension. Despite the genetic differences between the consortia, analysis by a gas chromatography-flame ionization detector showed few significant differences regarding the hydrocarbon degradation rates. Specifically, the YPD consortium presented higher degradation rates of C12 to C14 alkanes, while the BH consortium showed a significant increase in the degradation of some polycyclic aromatic hydrocarbons (PAHs). These data suggest that the enrichment of biosurfactant genes in the BH consortium could promote efficient hydrocarbon degradation, despite its lower taxonomical diversity compared to the consortium enriched in YPD medium. Together, these results showed that cultivation in a minimal medium supplemented with oil was an efficient strategy in selecting biosurfactant-producing microorganisms and highlighted the biotechnological potential of these bacterial consortia in waste treatment and bioremediation of impacted areas.

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