ABSTRACT
Abstract Purpose: Budget cuts among other factors undermine the use of state-of-the-art equipment by many research groups. This doesn't mean that their scientific data are not reliable or top-notch. Resort to adaptations is a recurrent need in their reality. The aim of this study was to assess whether scintigraphy with 99mTcO4 is effective in evaluating the functionality of thyroid grafts after cryopreservation in rats. Material and methods: 24 rats were randomly distributed into 3 groups: Control Group (CG), without surgical procedure, Hypothyroidism Group (HTG), submitted to total thyroidectomy, and Transplanted Group (TG), with total thyroidectomy and cryopreservation of the thyroid gland for 7 days followed by grafting of a thyroid lobe. A protocol using a gamma camera imaging was conducted fourteen weeks after transplantation, and the whole body 99mTc, focusing on the topic of heterotopic thyroid uptake was evaluated. Results: The images acquired had good quality with no noise and artifacts that could jeopardize its analysis. On the 14th day, HTG displayed no thyroid uptake, and the TG had a clear uptake of the thyroid graft in the topography of the biceps femoris muscle. Presented data also showed that both equipment spatial resolution and alignment (4.375 mm) did not interfere with the physiological uptake of 99mTc by the thyroid graft. Conclusion: The viability and functionality of cryopreserved thyroid autotransplantation in rats who underwent total thyroidectomy were successfully accessed by the scintigraphy protocol developed. HIGHLIGHTS Adaptations in validated methods are a recurrent trend due to limited budgets which does not diminish their functionality. Scintigraphy with 99mTcO4 is effective in evaluating the functionality of thyroid grafts after cryopreservation in rats. It is possible to adapt human SPECT for other animals for clinical and research purposes.
ABSTRACT
RESUMO O objetivo do estudo foi o de analisar o valor preditivo do escore MELD (Model for End-Stage Liver Disease) na sobrevida de médio e longo prazo em pacientes portadores de carcinoma hepatocelular (CHC), transplantados no Brasil. O estudo foi registrado no PROSPERO (International Prospective Register of Systematic Reviews), sob o nº 152.363. Os critérios de inclusão basearam-se nas recomendações PRISMA. A pesquisa foi realizada nos bancos de dados indexados do Lilacs, SciELO, Pubmed e Cochrane Library, e utilizou como estratégia de busca os termos MeSH: ((("Meld Score") OR "Model for End-Stage Liver Disease") AND "Hepatocellular Carcinoma") AND ("Brazil"). Foram incluídos artigos com texto completo, publicados a partir de janeiro de 2006 até outubro de 2019. A busca inicial encontrou 162 artigos. Após a leitura dos resumos e textos completos disponíveis, foram excluídos 156 artigos, totalizando seis artigos para análise qualitativa. Embora o número reduzido de artigos elegíveis tenha sido um fator limitante do estudo, nossos resultados corroboraram parcialmente aos encontrados nos EUA, Reino Unido e Irlanda. Nestes países, ao contrário do Brasil, o modelo prognóstico MELD mostrou forte associação com a sobrevida pós-transplante hepático. No entanto, a baixa capacidade preditiva do modelo em médio e longo prazo, foi similar ao nosso estudo. Configura-se a premência do desenvolvimento e validação de um modelo de sobrevida pós-transplante aos portadores de CHC, aperfeiçoando o sistema de alocação de órgãos no Brasil.
ABSTRACT This study aimed to analyse the predictive value of Model For End-Stage Liver Disease (MELD) score on medium- and long-term survival in transplanted hepatocellular carcinoma (HCC) patients in Brazil. The study was registered with International Prospective Register of Systematic Reviews (PROSPERO) under N# 152,363. Inclusion criteria were based on Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) recommendations. The search was performed on the indexed databases of Lilacs, SciELO, PubMed, and Cochrane Library, and used as search strategy the following Medical Subject Headings (MeSH) terms: ((("MELD Score") OR "Model For End-Stage Liver Disease") AND "Hepatocellular Carcinoma") AND ("Brazil"). We included full-text articles published from January 2006 to October 2019. The initial search found 162 articles. After reading the available abstracts and full texts, 156 articles were excluded, totaling six articles for qualitative analysis. Although the small number of eligible articles was a limiting factor of the study, our results partially corroborated those found in the United States, United Kingdom, and Ireland. In these countries, unlike Brazil, MELD prognostic model has shown a strong association with post-liver transplant (LT) survival. However, the low predictive capacity of the model in medium- and long-term has been similar to the one of our study. The urgency of the development and validation of a post-transplant survival model for patients with HCC is set, improving the organ allocation system in Brazil.
Subject(s)
Humans , Carcinoma, Hepatocellular/surgery , Liver Neoplasms/surgery , Prognosis , Tissue and Organ Procurement , Brazil/epidemiology , Survival Rate , Predictive Value of Tests , Retrospective Studies , Liver Transplantation , Carcinoma, Hepatocellular/mortality , Liver Neoplasms/mortalityABSTRACT
Abstract Purpose: To evaluate the actual incidence of both microlithiasis and acute cholecystitis during treatment with intravenous ceftriaxone in a new rabbit model. Methods: New Zealand rabbits were treated with intravenous ceftriaxone or saline for 21 days. Ultrasound monitoring of the gallbladder was performed every seven days until the 21st day when histopathology, immunohistochemistry for proliferating cell nuclear antigen (PCNA), pro-caspase-3 and CD68, liver enzyme biochemistry, and chromatography analysis of the bile and sediments were also performed. Results: All animals treated with ceftriaxone developed acute cholecystitis, confirmed by histopathology (P<0.05) and biliary microlithiasis, except one that exhibited sediment precipitation. In the group treated with ceftriaxone there was an increase in pro-caspase-3, gamma-glutamyl transpeptidase concentration, PCNA expression and in the number of cells positive for anti-CD68 (P<0.05). In the ceftriaxone group, the cholesterol and lecithin concentrations increased in the bile and a high concentration of ceftriaxone was found in the microlithiasis. Conclusion: Ceftriaxone administered intravenously at therapeutic doses causes a high predisposition for lithogenic bile formation and the development of acute lithiasic cholecystitis.