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1.
Trop Anim Health Prod ; 56(6): 193, 2024 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-38958783

RESUMO

The objective of the study was to evaluate the effect of the inclusion of cocoa bran in the diet of lambs and its effect on reproductive parameters. For this, 40 lambs were randomly assigned to four treatments, and including 0, 10, 20 and 30% levels of cocoa bran in the concentrate. Blood was collected to measure cholesterol and testosterone and semen for physical and morphological evaluation; testicular biometry and morphometry were also evaluated. There was significant difference (P < 0.05) in body weight and tubulosomatic index between the lambs in the control treatment and those in the 30% cocoa bran treatment. There was no difference in testicular biometry, physical and morphological parameters of fresh semen, testicular morphometry, and volumetric ratio between lambs in all the treatments (P < 0.05). In addition, there was no difference in plasma cholesterol or testosterone concentration (P > 0.05). Thus, it is possible to include up to 30% of cocoa bran in diet without affecting the reproductive parameters of lambs.


Assuntos
Ração Animal , Colesterol , Dieta , Carneiro Doméstico , Testículo , Testosterona , Animais , Masculino , Ração Animal/análise , Dieta/veterinária , Testículo/anatomia & histologia , Carneiro Doméstico/fisiologia , Testosterona/sangue , Colesterol/sangue , Colesterol/análise , Cacau/química , Reprodução , Sêmen/fisiologia , Fenômenos Fisiológicos da Nutrição Animal , Distribuição Aleatória , Ovinos/fisiologia
2.
Rev Gastroenterol Peru ; 43(4): 364-367, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38228303

RESUMO

Plexiform fibromyxoma (PF) is a rare mesenchymal neoplasm of the stomach usually arising in the gastric antrum, and its main differential diagnosis is gastrointestinal stromal tumor. Most common symptoms are hematemesis, anemia. Immunohistochemically, positivity for smooth muscle actin (SMA) and vimentin suggests the diagnosis of PF. We report the case of a 56-year-old female patient with a 30-day history of nausea at presentation 4 years ago. Gastroscopy at that time revealed a subepithelial lesion (SEL) in the gastric antrum, measuring approximately 20 mm in diameter, with leakage of serous fluid after biopsy. Histopathology showed only an inflammatory process. Follow-up gastroscopies were performed 24, 36, and 48 months later, with surveillance biopsy at each follow-up. The last gastroscopies showed changes in lesion appearance, reduction in size, and absence of fluid leakage. Histopathology showed bland spindle cell proliferation, with a vaguely plexiform/multinodular pattern, in a fibromyxoid stroma with an arborizing capillary network without mitoses. The tumor cells were positive for SMA and negative for DOG1, CD117, CD34, S100, desmin, EMA, CD10, calponin, and beta-catenin. The choice of treatment and follow-up depends on the SEL features, but because no cases of malignancy or metastatic disease have previously been reported, the patient chose a conservative approach.


Assuntos
Fibroma , Tumores do Estroma Gastrointestinal , Neoplasias Gástricas , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/patologia , Biomarcadores Tumorais , Tumores do Estroma Gastrointestinal/diagnóstico , Fibroma/diagnóstico , Fibroma/patologia
3.
Chemistry ; 27(10): 3517-3525, 2021 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-33330997

RESUMO

Aza-boron dipyrromethenes (aza-BODIPYs) presenting a benzothiadiazole substitution on upper positions are described. The strong electron-withdrawing effect of the benzothiadiazole moiety permits enhancement of the accepting strength and improves the delocalization of the aza-BODIPY core to attain a significant degree of electronic communication between the lower donating groups and the upper accepting groups. The nature of the intramolecular charge transfer is studied both experimentally and theoretically. Linear spectroscopy highlighted the strongly redshifted absorption and emission of the synthesized molecules with recorded fluorescence spectra over 1000 nm. Nonlinear optical properties were also investigated. Strong enhancement of the two-photon absorption of the substituted dyes compared with the unsubstituted one (up to 4520 GM at 1300 nm) results in an approximately 15-20 % improvement of the optical power limiting performances. These dyes are therefore a good starting point for further improvement of optical power limiting in the short-wave IR range.

4.
Neurol Sci ; 42(2): 479-489, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33409828

RESUMO

OBJECTIVE: To describe the clinical, neurological, neuroimaging, and cerebrospinal fluid (CSF) findings associated with encephalopathy in patients admitted to a COVID-19 tertiary reference center. METHODS: We retrospectively reviewed records of consecutive patients with COVID-19 evaluated by a consulting neurology team from March 30, 2020 through May 15, 2020. RESULTS: Fifty-five patients with confirmed SARS-CoV-2 were included, 43 of whom showed encephalopathy, and were further divided into mild, moderate, and severe encephalopathy groups. Nineteen patients (44%) had undergone mechanical ventilation and received intravenous sedatives. Eleven (26%) patients were on dialysis. Laboratory markers of COVID-19 severity were very common in encephalopathy patients, but did not correlate with the severity of encephalopathy. Thirty-nine patients underwent neuroimaging studies, which showed mostly non-specific changes. One patient showed lesions possibly related to CNS demyelination. Four had suffered an acute stroke. SARS-CoV-2 was detected by RT-PCR in only one of 21 CSF samples. Two CSF samples showed elevated white blood cell count and all were negative for oligoclonal bands. In our case series, the severity of encephalopathy correlated with higher probability of death during hospitalization (OR = 5.5 for each increment in the degree of encephalopathy, from absent (0) to mild (1), moderate (2), or severe (3), p < 0.001). CONCLUSION: In our consecutive series with 43 encephalopathy cases, neuroimaging and CSF analysis did not support the role of direct viral CNS invasion or CNS inflammation as the cause of encephalopathy.


Assuntos
Encefalopatias/etiologia , COVID-19/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Encefalopatias/líquido cefalorraquidiano , Encefalopatias/diagnóstico por imagem , Encefalopatias/imunologia , COVID-19/mortalidade , COVID-19/terapia , Feminino , Mortalidade Hospitalar , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Índice de Gravidade de Doença , Centros de Atenção Terciária
5.
Cytopathology ; 32(1): 50-56, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32816310

RESUMO

INTRODUCTION: Preoperative diagnostic imaging of pancreatic solid pseudopapillary neoplasms (SPNs) is challenging. A few studies have investigated the role of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) for the diagnosis of SPN. We investigated the diagnostic yield of cell-blocks and immunohistochemistry (IHC) for SPN using EUS-FNA specimens without cytological evaluation. PATIENTS AND METHODS: We retrospectively analysed the histopathology records of patients with suspected SPN, who underwent EUS-FNA biopsy between January 1997 and January 2020. Diagnosis based on cell-blocks (haematoxylin-eosin staining with complementary IHC) was compared with the definitive surgical diagnosis. RESULTS: This study included 25 patients (24 were women). Patients' mean age was 33.7 years (range 12-78 years). The most common symptom was abdominal pain. SPN was an incidental finding in 52% of the patients. The mean lesion size was 4.3 cm (range 1.2-11.4 cm), and the most common endosonographic features included solid-cystic (56%) or solid (40%) tumours. Final diagnoses included SPNs (n = 23) and non-functioning neuroendocrine tumours (n = 2). The overall accuracy of EUS-FNA was 80%. Tumour cells showed immunopositivity for ß-catenin, CD10, CD99 and progesterone receptor (PR) in 93.7%, 87.5%, 83.3% and 66.6% of patients, respectively. No SPN showed immunopositivity for chromogranin A. CONCLUSIONS: Intention-to-diagnose analysis showed that the diagnostic accuracy of EUS-FNA for SPNs using cell blocks and complementary IHC without cytological evaluation was fairly good. Evaluation of ß-catenin, CD 10, CD99 and PR expression must be included in the IHC panel for diagnostic confirmation of SPNs using EUS-FNA biopsy specimens.


Assuntos
Pâncreas/patologia , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/patologia , Antígeno 12E7/metabolismo , Adolescente , Adulto , Idoso , Criança , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico/métodos , Endossonografia/métodos , Feminino , Humanos , Imuno-Histoquímica/métodos , Masculino , Pessoa de Meia-Idade , Neprilisina/metabolismo , Pâncreas/metabolismo , Neoplasias Pancreáticas/metabolismo , Receptores de Progesterona/metabolismo , Estudos Retrospectivos , Adulto Jovem , beta Catenina/metabolismo
6.
Rev Panam Salud Publica ; 44: e117, 2020.
Artigo em Português | MEDLINE | ID: mdl-33093848

RESUMO

OBJECTIVE: To map the implementation characteristics of Medicine programs established in Brazilian federal universities from 2013 onwards. METHODS: A qualitative and quantitative exploratory study was performed. Newly created Medicine programs were identified in federal universities, with analysis of pedagogical frameworks and interviews with students, faculty, and health care professionals from associated health care services. Data were analyzed using qualitative and quantitative methods. RESULTS: Thirty new Medicine programs were identified, of which 24 were visited. All the new programs were located outside large urban centers and capitals, across the five Brazilian macro-regions, and adopted various formative configurations in an attempt to overcome fragmentation of content with active methodologies and formative evaluations. The healthcare network is used for training as a means to meet the challenge of academic-health service-community integration, with the aim of providing critical education focused on public health. The establishment of the Medicine programs facilitated to a limited extent the retention of faculty in remote areas and promoted the access of local students and the creation of residency programs, which are powerful strategies to enhance the retention of medical professionals. CONCLUSIONS: Variations were observed among the programs in the manner of implementation and adherence to the National Curriculum Guidelines for Medicine, published in 2014. The construction of medical training models that appropriately address local specificities and the requirements of the Unified Health System in its formative role for health care may contribute to reduce health inequalities.


OBJETIVO: Mapear las características de implementación de los programas de Medicina establecidos en las universidades federales brasileñas a partir de 2013. MÉTODOS: Se realizó un estudio exploratorio cualitativo y cuantitativo. Se identificaron los programas de medicina recién creados en las universidades federales, se anlizaron los marcos pedagógicos y se entrevistaron estudiantes, profesores y profesionales de la salud de los servicios de salud asociados. Los datos fueron analizados usando métodos cualitativos y cuantitativos. RESULTADOS: Se identificaron 30 nuevos programas de medicina, de los cuales se visitaron 24. Todos los nuevos programas se ubicaron fuera de los grandes centros urbanos y capitales en las cinco macrorregiones brasileñas y adoptaron diversas configuraciones formativas en un intento de superar la fragmentación de contenido con metodologías activas y evaluaciones formativas. La red de salud se empleó para la formación como un medio para facilitar la integración entre los ámbitos académico, de servicios de salud y la comunidad, con el objetivo de proporcionar una educación crítica centrada en la salud pública. El establecimiento de los programas de medicina facilitó en cierta medida la retención del profesorado en zonas remotas y promovió el acceso de los estudiantes locales y la creación de programas de residencia, que son estrategias importantes para mejorar la retención de los profesionales médicos. CONCLUSIONES: Se observaron variaciones entre los programas en cuanto a la manera de aplicar y cumplir las Directrices Curriculares Nacionales de Medicina, publicadas en 2014. La construcción de modelos de formación médica que aborden adecuadamente las especificidades locales y los requisitos del Sistema Único de Salud en su función formativa para la atención de la salud puede contribuir a reducir las desigualdades en materia de salud.

7.
Cytopathology ; 29(6): 531-536, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30218589

RESUMO

OBJECTIVES: To evaluate the diagnostic yield of the cell block (CB) technique with immunohistochemistry in patients with mesenchymal neoplasms of the gastrointestinal tract collected by endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). METHODS: Tissue samples from consecutive patients with subepithelial lesions collected by EUS-FNA, without analysis by on-site cytopathology, were evaluated by the same pathologist only using CBs in AAF fixative. Sections were stained with haematoxylin-eosin and underwent complementary immunohistochemical staining for SMA, CD117, DOG-1 and S100 in the presence of mesenchymal neoplasms. Specimens were defined as diagnostic when sufficient tissue was present for histopathological evaluation and immunohistochemistry analysis. If they were insufficient for complete evaluation, the specimens were considered nondiagnostic. RESULTS: Between September 2012 and December 2016, a total of 158 patients (median age: 57 years, 64.5% women) underwent EUS-FNA with an average of three needle passes for every lesion. The median lesion size was 17 mm. There were 113 mesenchymal neoplasms confirmed by immunohistochemistry (66 leiomyomas, 44 GISTs, two schwannomas, one leiomyosarcoma). The overall diagnostic yield of CBs was 84.17%. However, diagnosis was obtained in 98.5% (133/135) of the cases after exclusion of 23 cases in which EUS-FNA sampling was insufficient or without tumoural tissue. Only two mesenchymal neoplasms were not confirmed by CBs even after immunohistochemistry. CONCLUSIONS: CBs collected by EUS-FNA and analysed by immunohistochemistry showed a high diagnostic yield in patients with mesenchymal neoplasms, even without on-site cytopathology.


Assuntos
Tumores do Estroma Gastrointestinal/diagnóstico , Tumores do Estroma Gastrointestinal/patologia , Trato Gastrointestinal/patologia , Mesoderma/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Diagnóstico Diferencial , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico/métodos , Feminino , Humanos , Imuno-Histoquímica/métodos , Masculino , Pessoa de Meia-Idade , Agulhas , Adulto Jovem
8.
Surg Endosc ; 29(5): 1156-60, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-25171883

RESUMO

BACKGROUND AND AIMS: Postoperative esophageal strictures frequently recur. We assessed the efficacy of injecting triamcinolone after bougie dilation in comparison to dilation alone. METHODS: In a double-blind randomized fashion, 19 patients (68% male with mean age of 53-years old) with non-dilated esophagogastric complex strictures after esophagectomy with gastric pull-up were assigned to receive dilation alone (control) or 40 mg of triamcinolone at the borders of the wall lacerations caused by the bougienage in each dilation session during the study follow-up. Dysphagia and complications were assessed at 1, 2, and 6 months. Primary end-point was to be dysphagia-free. RESULTS: After 1 month of the beginning of therapy, 4 patients in the steroid group were without dysphagia, in comparison to 0 patient in the control group (P = 0.021). Six months after endoscopic therapy, 62% of the cases in the triamcinolone group versus none in the control group were dysphagia-free (P = 0.009). There was no perforation nor hemorrhage. CONCLUSIONS: Injecting triamcinolone after every dilation session next to or at the borders of the lacerations caused by the dilators, results in a significant improvement or resolution of dysphagia.


Assuntos
Dilatação/métodos , Estenose Esofágica/terapia , Esofagectomia/efeitos adversos , Junção Esofagogástrica/patologia , Glucocorticoides/administração & dosagem , Triancinolona/administração & dosagem , Adulto , Idoso , Transtornos de Deglutição/etiologia , Transtornos de Deglutição/terapia , Método Duplo-Cego , Estenose Esofágica/etiologia , Esofagoscopia , Feminino , Humanos , Injeções Intralesionais , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Recidiva
9.
Dig Endosc ; 27(3): 361-7, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25115615

RESUMO

BACKGROUND AND AIM: Several studies suggest that non-polypoid lesions (NPL) show higher aggressiveness than polypoid lesions, particularly depressed lesions. The present study aimed to assess the prevalence of NPL and the presence of advanced histology in a Brazilian population. METHODS: Two thousand and sixty-seven superficial neoplastic lesions diagnosed in 1135 patients were analyzed. Lesions were classified as polypoid and non-polypoid (flat and depressed) types, and evaluated for site, size, and histology (adenoma with grade of dysplasia, or early cancer). RESULTS: Prevalence of NPL was 46.5%. NPL predominated in the right colon (62.9%), whereas polypoid lesions were detected mainly in the left colon (53.2%) (P < 0.001). NPL had a 34% higher probability of occurring in the right colon than polypoid lesions (P < 0.001). NPL were smaller than polypoid lesions (P = 0.03). There were 208 lesions >10 mm, of which 40 (19.2%) had advanced histology: 13% (18/138) of polypoid lesions; 27.3% (18/66) of flat lesions; and 100% (4/4) of depressed lesions (P < 0.001). Among 1859 neoplasms ≤10 mm, only 18 (1%) had advanced histology, and 15 of them were depressed lesions (P < 0.001). Advanced histology was more commonly detected in NPL than in polypoid lesions (P = 0.007), with significant difference in size (P < 0.001). NPL showed more advanced histology than polypoid lesions (OR 2.06; P = 0.01), especially depressed lesions (OR 36.35; P < 0.001). Among all neoplasms, the prevalence of depressed lesions was 2.2%. CONCLUSION: NPL showed high prevalence and higher aggressiveness than polypoid lesions, especially the depressed type.


Assuntos
Adenoma/epidemiologia , Adenoma/patologia , Colonoscopia/métodos , Neoplasias Colorretais/epidemiologia , Neoplasias Colorretais/patologia , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Estudos de Coortes , Pólipos do Colo/epidemiologia , Pólipos do Colo/patologia , Intervalos de Confiança , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Prevalência , Estudos Retrospectivos , Distribuição por Sexo
10.
Scand J Gastroenterol ; 49(1): 114-20, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-24188361

RESUMO

OBJECTIVE: Widespread use of imaging procedures has promoted a higher identification of incidental pancreatic cysts (IPCs). However, little is known as to whether endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) could change the management strategy of patients having IPCs. This study has aimed to evaluate the management impact of EUS-FNA on IPCs. MATERIAL AND METHODS: Patients with pancreatic cysts (PCs) who were referred to EUS-FNA were recruited prospectively. The referring physicians were questioned about the management strategy for these patients before and after EUS-FNA. The impact of EUS-FNA on management was then evaluated. RESULTS: A total of 302 PC patients were recruited. Of these, 159 (52.6%) patients had asymptomatic IPCs. The average size was 2.3 cm (range: 0.2-7.1 cm), and 110 patients having smaller than 3 cm sized cysts. Lesions were located in the pancreatic head in 96 (61%) cases, and most patients (94%) had only a single cyst. The final diagnoses, obtained by EUS-FNA (91) and surgery (68), were 93 (58%) benign lesions, 36 (23%) cysts with malignant potential, 14 (9%) noninvasive malignancies, 10 (6%) malignant precursor lesions (PanIN), and 6 (4%) invasive malignancies. Management strategy changed significantly after EUS-FNA in 114 (71.7%) patients: 43% of the cases were referred to surgery, 44% of the patients were discharged from surveillance, and 13% of the cases were given further periodical imaging tests. CONCLUSION: EUS-FNA has a management impact in almost 72% of IPCs, with a major influence on the management strategy, either discharge rather than surgical resection or surgery rather than additional follow up.


Assuntos
Cistadenoma/patologia , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico , Pâncreas/patologia , Cisto Pancreático/patologia , Cisto Pancreático/terapia , Neoplasias Pancreáticas/patologia , Lesões Pré-Cancerosas/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Cistadenoma/cirurgia , Feminino , Humanos , Achados Incidentais , Masculino , Pessoa de Meia-Idade , Neoplasias Pancreáticas/cirurgia , Lesões Pré-Cancerosas/cirurgia , Estudos Prospectivos , Conduta Expectante , Adulto Jovem
12.
BMC Gastroenterol ; 13: 63, 2013 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-23578194

RESUMO

BACKGROUND: Metastases to the pancreas are rare, and usually mistaken for primary pancreatic cancers. This study aimed to describe the histology results of solid pancreatic tumours obtained by endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for diagnosis of metastases to the pancreas. METHODS: In a retrospective review, patients with pancreatic solid tumours and history of previous extrapancreatic cancer underwent EUS-FNA from January/1997 to December/2010. Most patients were followed-up until death and some of them were still alive at the end of the study. The performance of EUS-FNA for diagnosis of pancreatic metastases was analyzed. Symptoms, time frame between primary tumour diagnosis and the finding of metastases, and survival after diagnosis were also analyzed. RESULTS: 37 patients underwent EUS-FNA for probable pancreas metastases. Most cases (65%) presented with symptoms, especially upper abdominal pain (46%). Median time between detection of the first tumour and the finding of pancreatic metastases was 36 months. Metastases were confirmed in 32 (1.6%) cases, 30 of them by EUS-FNA, and 2 by surgery. Other 5 cases were non-metastatic. Most metastases were from lymphoma, colon, lung, and kidney. Twelve (32%) patients were submitted to surgery. Median survival after diagnosis of pancreatic metastases was 9 months, with no difference of survival between surgical and non-surgical cases. Sensitivity, specificity, positive and negative predictive values, and accuracy of EUS-FNA with histology analysis of the specimens for diagnosis of pancreatic metastases were, respectively, 93.8%, 60%, 93.8%, 60% and 89%. CONCLUSION: EUS-FNA with histology of the specimens is a sensitive and accurate method for definitive diagnosis of metastatic disease in patients with a previous history of extrapancreatic malignancies.


Assuntos
Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico , Pâncreas/patologia , Neoplasias Pancreáticas/patologia , Neoplasias Pancreáticas/secundário , Dor Abdominal/etiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Pancreáticas/cirurgia , Valor Preditivo dos Testes , Estudos Retrospectivos , Análise de Sobrevida
13.
GE Port J Gastroenterol ; 30(5): 375-383, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37868635

RESUMO

Introduction: Imaging diagnosis of pancreatic solid-pseudopapillary neoplasms (SPNs) is difficult. Preoperative diagnosis by endosonography-guided fine-needle aspiration (EUS-FNA) is possible and has been reported in the literature in pancreatic tumors. However, its usefulness is still controversial. The aim of this study was to determine the accuracy of the EUS-FNA in the diagnosis of patients with SPN and describe the findings in computerized tomography (CT), magnetic resonance cholangiopancreatography imaging (MRI/MRCP), and EUS therefore comparing the imaging methods alone to the findings of microhistology (McH) obtained by EUS-FNA. Materials and Methods: We retrospectively reviewed the medical records of patients undergoing EUS-FNA with suspected SPN in imaging studies in 5 Brazilian high-volume hospitals (two university hospitals and three private hospitals). The demographic data; findings in CT, MRI/MRCP, and EUS; and McH results obtained by EUS-FNA were noted prospectively. The final diagnosis was obtained after the anatomopathological examination of the surgical specimen in all patients (gold standard), and we compared the results of CT, MRI/MRCP, EUS, and the McH with the gold standard. Results: Fifty-four patients were included in the study, of which 49 (90.7%) were women with an average age of 33.4 (range 11-78) years. The most common symptom presented was abdominal pain, present in 35.2% patients. SPN was detected incidentally in 32 (59%) patients. The average size of the tumors was 3.8 cm (SD: 2.26). The most common finding at EUS was a solid, solid/cystic, and cystic lesion in 52.9%, 41.1%, and 7.8% patients, respectively. The final diagnosis was 51 patients with SPN and 3 with nonfunctioning pancreatic neuroendocrine tumors (NF-NET). The correct diagnosis was made by CT, MRI/MRCP, EUS isolated, and EUS-FNA in 21.9%, 28.88%, 64.71%, and 88.24%, respectively. EUS-FNA associated with CT and MRI increased diagnostic performance from 22.72% to 94.11% and from 29.16% to 94.11%, respectively. Conclusions: SPN are rare, incidentally identified in most cases, and affect young women. Differential diagnosis between SPN, NF-NET, and other types of tumors with imaging tests can be difficult. EUS-FNA increases preoperative diagnosis in case of diagnostic doubt and should be used whenever necessary to rule out NF-NET or other type of solid/cystic nodular lesion of the pancreas.


Introdução: O diagnóstico por imagem da neoplasia pseudopapilar sólida do pâncreas (NPS) é difícil. O diagnóstico pré-operatório obtido pela endosonografia com punção aspirativa por agulha fina (USE-PAF) é possível e tem sido relatado na literatura em tumores do pâncreas. No entanto, sua indicação é controversa e merece discussão. O objetivo do estudo foi determinar a acurácia da USE-PAF no diagnóstico de pacientes com NPS, descrever os achados da tomografia computadorizada (TC), colangiopancreatografia por ressonância magnética (RM/ CPRM) e USE, comparando os métodos de imagem isolados aos achados da microhistologia (McH) obtida pela USE-PAF. Material e Métodos: Revisamos retrospectivamente os prontuários de pacientes submetidos à USE-PAF com suspeita de NPS em exames de imagem de 5 hospitais brasileiros de alto volume (dois universitários e três privados). Foram anotados prospectivamente os dados demográficos, os achados da TC, RM/CPRM e USE e o resultado da McH obtida pela USE-PAF. O diagnóstico final foi obtido após o anatomopatológico da peça operatória em todos os pacientes (padrão-ouro). Comparamos os resultados da TC, RM/CPRM, EUS isoladas e da McH obtida pela USE-PAF com o padrão-ouro. Resultados: Cinquenta e quatro pacientes foram incluídos no estudo, 49 (90.7%) eram mulheres com média de idade de 33.4 (11­78) anos. O sintoma mais frequente foi dor abdominal, presente em 35.2%. A NPS foi detectada acidentalmente em 32 (59%) pacientes. O tamanho médio da lesão foi de 3.8 cm (SD: 2.26). O achado mais comum à USE foi lesão sólida, sólida/ cística e cística em 52.9%, 41.1% e 7.8%, respectivamente. O diagnóstico final foi NPS (51) e tumor neuroendócrino pancreático não funcionante [NF-NET] (3). O diagnóstico correto feito pela TC, RM, USE e USE-PAF foi feito em 21.9%, 28.9%, 64.7% e 88.2%, respectivamente. A USEPAF associada a TC e a RM aumentou o desempenho diagnóstico de 21.9% para 94.1% e de 28.8% para 94.1%, respectivamente. Conclusões: NPS são raras, identificadas de forma acidental na maioria dos casos e afetam principalmente mulheres jovens. O diagnóstico diferencial entre NPS, NF-NET e outros tipos de lesões com exames de imagem isolados pode ser difícil. A USE-PAF aumenta a chance do diagnóstico pré-operatório em caso de dúvida diagnóstica e deve ser usado sempre que necessário para descartar NF-NET ou outro tipo de lesão nodular sólida ou sólido/cística do pâncreas.

15.
J Phys Chem A ; 116(47): 11519-30, 2012 Nov 29.
Artigo em Inglês | MEDLINE | ID: mdl-23102256

RESUMO

Several new bis-phosphine platinum(II) complexes with 2,5-diaryl-substituted oxazole-containing alkyne ligands have been synthesized and optically characterized in solution. Measurements of nonlinear absorption showed strong attenuation of laser light at 532 and 600 nm. The light absorption of the Pt complexes was shifted from the near-UV region for the ground state to the red region for the excited triplet state, and was associated with large extinction coefficients. The optical limiting effect can be explained by triplet-triplet excited state absorption in conjunction with fast excited singlet-to-triplet intersystem crossing and slow triplet-to-ground-state decay, in comparison with the pulse length of the laser. DFT calculations show good predictability of the S(0)-S(1) and S(0)-T(1) energy gaps and offer insight into the interaction strength between Pt and the alkyne ligands. The use of this type of ligand, with weak absorption for the Pt(II) complexes in the visual wavelength range as a key feature, enables the possibility to further improve these molecular systems for nonlinear absorption applications.


Assuntos
Dinâmica não Linear , Fenômenos Ópticos , Compostos Organometálicos/química , Oxazóis/química , Platina/química , Teoria Quântica , Absorção , Modelos Moleculares , Conformação Molecular , Compostos Organometálicos/síntese química
16.
Arq Neuropsiquiatr ; 80(5 Suppl 1): 42-52, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35976308

RESUMO

Normal pressure hydrocephalus (NPH) has been a topic of debate since its introduction in publications. More frequent in the elderly population, it is characterized by gait disturbance, urinary urge incontinence and cognitive decline. Therefore, it is a clinical-radiological entity with relatively common findings for the age group, which together may have greater specificity. Therefore, its diagnosis must be careful for an adequate selection of patients for treatment with ventricular shunt, since the symptoms are potentially reversible. The tap test has a high positive predictive value as a predictor of therapeutic response, but a negative test does not exclude the possibility of treatment. Scientific efforts in recent years have been directed towards a better understanding of NPH and this narrative review aims to compile recent data from the literature in a didactic way for clinical practice.


Assuntos
Hidrocefalia de Pressão Normal , Hidrocefalia , Idoso , Humanos , Hidrocefalia de Pressão Normal/diagnóstico por imagem , Valor Preditivo dos Testes
17.
Anim Reprod ; 18(3): e20210027, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34745356

RESUMO

The effects of docosahexaenoic acid (DHA) in the diluent for cryopreservation of goat semen on seminal quality and the optimal levels to be used were evaluated. After collection, semen was pooled and physically evaluated, then divided into four aliquots with different DHA levels in the diluent: 0, 10, 20, and 30 ng mL-1. The semen was cryopreserved in a TK 3000® freezing machine and then thawed for assessment at 37 °C. Sperm motility and vigor, membrane integrity, acrosomal integrity, mitochondrial activity, and sperm chromatin compaction were evaluated after thawing. A completely randomized design was used. For normally distributed variables, ANOVA and regression analysis were used to test for differences between treatments, and for non-parametric data, the Kruskal Wallis test was used at the 5% significance level. There were no differences among groups in terms of membrane integrity, acrosomal integrity, or chromatin compaction. There was a decrease in class I mitochondrial activity with increasing DHA level (P<0.05), but no differences in classes II, III, and IV (P>0.05). The inclusion of 10 to 30 ng mL-1 of DHA in the diluent did not result in improvements in seminal quality parameters after thawing, with some impairment observed in the mitochondrial activity of the sperm cells.

19.
J Phys Chem A ; 114(10): 3431-42, 2010 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-20148542

RESUMO

A series of four new trans-diphosphine Pt(II) diacetylide complexes, with a thiophene and two benzenoid rings in each acetylide ligand, have been synthesized and characterized with respect to optical absorption, spectrally and time-resolved luminescence, and optically nonlinear properties such as two-photon absorption cross section and optical power limiting. Density functional theory (DFT) calculations of a few ground state conformations of three Pt(II) diacetylide structures showed similar total energy for each geometry-optimized rotamer but some differences in the vertical excitation energies and in the ligand-to-metal charge-transfer character. The wavelengths of the calculated excitations were found to be red-shifted compared with peaks in the optical absorption spectra, but the general trends and shifts of wavelengths between the different structures are well reproduced. Static emission spectra for degassed samples in THF solution of the larger compounds showed small Stokes shifts and low fluorescence quantum yields, indicating fast intersystem crossing to the triplet manifold. More pronounced differences between the compounds were displayed in the phosphorescence data, in terms of spectral emission wavelengths and decay times. For instance, the phosphorescence decay of the compound with the thiophene ring close to the Pt center was found to be significantly faster than for the other compounds. A possible relationship between triplet lifetime and conformation of the compounds is discussed. It was also demonstrated that the quenching of the excited triplet states in air-saturated samples involves energy transfer to the oxygen triplet state, and subsequent generation of singlet oxygen showing the typical emission at approximately 1275 nm. The amount of produced singlet oxygen followed the phosphorescence yields of the solute molecules. Two-photon absorption cross sections (sigma(2)) were measured and showed values on the order of 10 GM at 780 nm for all compounds. Optical power limiting measurements of the new complexes in THF using 5 ns pulses, showed only slightly better performance at the wavelength of 532 nm compared to that of similar platinum compounds with only two aryl rings in each ligand. At 600 nm the complexes with three aryl rings were significantly better optical limiters than the smaller compounds with two aryl rings in the ligands.

20.
J Thorac Dis ; 12(8): 4476-4495, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32944361

RESUMO

BACKGROUND: Obstructive sleep apnea (OSA) has a high prevalence, with an estimated 425 million adults with apnea hypopnea index (AHI) of ≥15 events/hour, and is significantly underdiagnosed. This presents a significant pain point for both the sufferers, and for healthcare systems, particularly in a post COVID-19 pandemic world. As such, it presents an opportunity for new technologies that can enable screening in both developing and developed countries. In this work, the performance of a non-contact OSA screener App that can run on both Apple and Android smartphones is presented. METHODS: The subtle breathing patterns of a person in bed can be measured via a smartphone using the "Firefly" app technology platform [and underpinning software development kit (SDK)], which utilizes advanced digital signal processing (DSP) technology and artificial intelligence (AI) algorithms to identify detailed sleep stages, respiration rate, snoring, and OSA patterns. The smartphone is simply placed adjacent to the subject, such as on a bedside table, night stand or shelf, during the sleep session. The system was trained on a set of 128 overnights recorded at a sleep laboratory, where volunteers underwent simultaneous full polysomnography (PSG), and "Firefly" smartphone app analysis. A separate independent test set of 120 recordings was collected across a range of Apple iOS and Android smartphones, and withheld for performance evaluation by a different team. An operating point tuned for mid-sensitivity (i.e., balancing sensitivity and specificity) was chosen for the screener. RESULTS: The performance on the test set is comparable to ambulatory OSA screeners, and other smartphone screening apps, with a sensitivity of 88.3% and specificity of 80.0% [with receiver operating characteristic (ROC) area under the curve (AUC) of 0.92], for a clinical threshold for the AHI of ≥15 events/hour of detected sleep time. CONCLUSIONS: The "Firefly" app based sensing technology offers the potential to significantly lower the barrier of entry to OSA screening, as no hardware (other than the user's personal smartphone) is required. Additionally, multi-night analysis is possible in the home environment, without requiring the wearing of a portable PSG or other home sleep test (HST).

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