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1.
Arq. ciências saúde UNIPAR ; 26(3)set-dez. 2022.
Article in Portuguese | LILACS | ID: biblio-1399004

ABSTRACT

Este trabalho teve como objetivo realizar uma revisão integrativa sobre a Ozonioterapia como prática complementar no tratamento de lesões em seres humanos. Efetuou-se busca sistematizada nos portais: Biblioteca virtual em saúde (BVS), Biblioteca virtual em saúde de medicinas tradicionais complementares e integrativas (BVS MTCI) e Business source complete (EBSCO) nas seguintes bases de dados: Literatura latino-americana e do caribe em ciências da saúde (LILACS), Base de dados de Enfermagem (BDENF) e Medical literature analysis and retrievel system Online (MEDLINE), com cruzamento dos descritores: ozônio; ferimentos; lesões; cicatrização de feridas. Após os critérios de inclusão serem aplicados, observou-se que dez artigos atingiram todos os critérios previamente definidos. Os estudos apontam que a Ozonioterapia apresenta resultados positivos como opção na terapêutica complementar de lesões. Porém, é um recurso terapêutico com baixa adesão. Faz se necessário maior empenho cientifico sobre a temática. PALAVRAS-CHAVE: Ozônio; Ferimentos; Lesões; Cicatrização de feridas.


Currently, there are several treatments as well as ozone therapy that aim to improve wounds. This work aimed to carry out an integrative review on Ozone Therapy as a complementary practice in the treatment of injuries in humans. A systematic search was conducted on the portals: Virtual Health Library (VHL), Virtual Health Library of Complementary and Integrative Traditional Medicines (VHL MTCI) and Business Source Complete (EBSCO) in the following databases: Latin American and Caribbean Literature in Health Science (LILACS) , Nursing Database (BDENF) and Online Medical Literature Review and Retrieval System (MEDLINE), by crossing descriptors: Ozone, Wounds and Injuries, Healing injuries. After the inclusion criteria were applied, it was observed that ten articles reached all the criteria previously defined. The studies indicate that Ozone therapy presents positive results as a complementary therapy option on wounds. However, it is a therapeutical resource with low adherence. It is necessary a greater scientific commitment on the theme.


Este trabajo tuvo como objetivo realizar una revisión integradora sobre la ozonoterapia como práctica complementaria en el tratamiento de lesiones en humanos. Se realizó una búsqueda sistemática en los siguientes portales: Biblioteca Virtual de Salud (BVS), Biblioteca Virtual de Salud de Medicinas Tradicionales, Complementarias e Integrativas (BVS MTCI) y Business Source Complete (EBSCO) en las siguientes bases de datos: Latin American and Caribbean Health Sciences Literature (LILACS), Nursing Database (BDENF) y Medical Literature Analysis and Retrieval System Online (MEDLINE), utilizando las palabras clave: ozono; heridas; lesiones; curación de heridas. Una vez aplicados los criterios de inclusión, se observó que diez artículos cumplían todos los criterios previamente definidos. Los estudios demostraron que la ozonoterapia tiene resultados positivos como opción terapéutica complementaria para las lesiones. Sin embargo, es un recurso terapéutico con un bajo cumplimiento. Es necesario un mayor esfuerzo científico sobre el tema.


Subject(s)
Wounds and Injuries/nursing , Wounds and Injuries/rehabilitation , Wounds and Injuries/therapy , Nursing , Ozone Therapy , Ozone/therapeutic use , Skin , Wound Healing/drug effects , Libraries, Digital , Health Resources
3.
Nursing (Säo Paulo) ; 25(292): 8688-8699, set. 2022.
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1399520

ABSTRACT

Objetivo: descrever o que tem sido escrito cientificamente sobre a adequação da assistência da enfermeira no centro cirúrgico no cenário da pandemia por Covid-19. Método: Trata-se de uma revisão integrativa de literatura. Como critérios de inclusão, elegeu-se: artigos completos disponíveis em português e inglês, publicados a partir de 2020, ano que deu início a pandemia até janeiro de 2022. Para organização e análise dos dados, recorreu-se ao Método de Análise de Conteúdo. Resultados: Foram selecionados 8 artigos. Como categorias de análise, emergiram os seguintes temas: o estabelecimento de protocolos operacionais específicos para a realização de cirurgias durante a pandemia da Covid-19 e a necessidade de readequação dos profissionais de saúde e a importância da enfermeira neste contexto. Conclusão: A enfermeira teve papel fundamental em todo o processo de estruturação e direcionamento do cuidado ao paciente, destacando seu potencial como protagonista no processo de cuidar em saúde. (AU)


Objective: to describe what has been scientifically written about the adequacy of nurse assistance in the surgical center in the context of the Covid-19 pandemic. Methodology: This is an integrative literature review. As inclusion criteria, the following were chosen: full articles available in Portuguese and English, published from 2020, the year the pandemic started until January 2022. For data organization and analysis, the Content Analysis Method was used . Results: Eight articles were selected. As categories of analysis, the following themes emerged: the establishment of specific operational protocols for performing surgeries during the Covid-19 pandemic and the need to readjust health professionals and the importance of the nurse in this context. Considerations: The nurse played a fundamental role in the entire process of structuring and directing patient care, highlighting her potential as a protagonist in the health care process.(AU)


Objetivo: describir lo que científicamente se ha escrito sobre la adecuación de los cuidados de enfermería en el centro quirúrgico en el contexto de la pandemia de la Covid-19. Método: Esta es una revisión integradora de la literatura. Como criterios de inclusión, se eligieron: artículos completos disponibles en portugués e inglés, publicados a partir de 2020, año de inicio de la pandemia, hasta enero de 2022. Para la organización y análisis de los datos, se utilizó el Método de Análisis de Contenido. Resultados: Se seleccionaron ocho artículos. Como categorías de análisis, surgieron los siguientes temas: el establecimiento de protocolos operativos específicos para la realización de cirugías durante la pandemia de Covid-19 y la necesidad de readecuación de los profesionales de la salud y la importancia del enfermero en este contexto. Conclusión: La enfermera jugó un papel fundamental en todo el proceso de estructuración y dirección del cuidado del paciente, destacando su potencial como protagonista en el proceso de atención a la salud.(AU)


Subject(s)
Skin , Infant, Premature , Infant, Newborn, Diseases , Nursing Care
4.
Arq. Asma, Alerg. Imunol ; 6(1): 116-121, jan.mar.2022. ilus
Article in English, Portuguese | LILACS | ID: biblio-1400117

ABSTRACT

Introdução: Mutações do gene da filagrina vêm sendo associadas, classicamente, a alterações da barreira epitelial em doenças alérgicas com comprometimento da pele e das superfícies mucosas. Particularmente na dermatite atópica, a relação entre filagrina, mecanismo fisiopatológico e evolução clínica tem sido demonstrada. Recentemente, alterações da barreira epitelial com redução da expressão da filagrina, também têm sido associadas a mecanismos imunológicos envolvidos na patogênese da esofagite eosinofílica. Devido a disfunções na barreira epitelial, microrganismos e alérgenos são capazes de penetrarem no epitélio da mucosa esofágica, assim como na dermatite atópica. Objetivo: Avaliar a possível correlação da expressão da filagrina com os achados histopatológicos em biópsias esofágicas de pacientes com esofagite eosinofílica. Métodos: A expressão da filagrina foi investigada in situ, por imuno-histoquímica, em biópsias esofágicas nos seguintes grupos: Grupo I, controle (n=8), amostras provenientes de pacientes saudáveis; Grupo II (n=27), amostras provenientes de pacientes com esofagite eosinofílica. Resultados: Os resultados demonstraram uma diminuição da expressão da filagrina na mucosa do esôfago de portadores de esofagite eosinofílica. Adicionalmente, a intensidade da marcação imuno-histoquímica foi menor na mucosa esofágica com maior infiltração de eosinófilos. Conclusão: A diminuição da expressão de filagrina pode ser um fenomeno fisiopatológico associado ao aumento da quantidade de eosinófilos na mucosa esofágica, podendo impactar na evolução clínica da esofagite eosinofílica.


Introduction:Filaggrin gene mutations have been classically associated with changes in the epithelial barrier in allergic diseases involving the skin and mucosal surfaces. Particularly in atopic dermatitis, the relationship between filaggrin, pathophysiological mechanism and clinical evolution hás been demonstrated. Recently, changes in the epithelial barrier with reduced expression of filaggrin have also been associated with immunological mechanisms involved in the pathogenesis of eosinophilic esophagitis. Due to dysfunction in the epithelial barrier, microorganisms and allergens are able to penetrate the epithelium of the esophageal mucosa, as well as in atopic dermatitis. Objective: To evaluated the possible correlation of filaggrin expression with histopathological findings in esophageal biopsies of patients with eosinophilic esophagitis. Methods: Filaggrin expression was investigated in situ by immunohistochemistry in esophageal biopsies in the following groups: Group I, control (n = 8), samples from healthy patients; Group II (n = 27), samples from patients with eosinophilic esophagitis. Results: The results demonstrated a decrease in the expression of filaggrin in the esophageal mucosa of patients with eosinophilic esophagitis. Additionally, the intensity of the immunohistochemical labeling was lower in the esophageal mucosa with greater infiltration of eosinophils. Conclusion: The reduction of filaggrin expression may be a pathophysiological phenomenon associated with an increase in the quantity of eosinophils in the esophageal mucosa, which may impact on the clinical evolution of eosinophilic esophagitis.


Subject(s)
Humans , Biopsy , Eosinophilic Esophagitis , Filaggrin Proteins , Patients , Skin , Immunohistochemistry , Allergens , Dermatitis, Atopic , Esophageal Mucosa , Mutation
5.
Rev. colomb. cancerol ; 26(1): 111-116, ene.-mar. 2022. graf
Article in Spanish | LILACS | ID: biblio-1407973

ABSTRACT

Resumen El Xeroderma Pigmentoso (XP) es un trastorno poco frecuente, autosómico recesivo y caracterizado por una extrema sensibilidad a la radiación ultravioleta (RUV) de la luz solar, que produce una reparación defectuosa del daño del ADN y como consecuencia, marcada predisposición al desarrollo de cáncer de piel. Clínicamente, se manifiesta por fotosensibilidad, cambios cutáneos pigmentarios y envejecimiento prematuro de la piel. Este trastorno afecta aproximadamente 1 de cada 250.000 habitantes por año en Estados Unidos. Presentamos el caso de una paciente de 12 años con un Xeroderma Pigmentoso detectado a los 6 meses, quien desarrolló una lesión ulcerada en la vertiente nasal izquierda con reporte de patología de Angiosarcoma (AS) con CD31, EGR y CD34 positivos. La paciente fue tratada con resección amplia de la lesión y quimioterapia adyuvante con Plaquitaxel y Doxorrubicina sin radioterapia.


Abstract Xeroderma Pigmentosum is a rare autosomal recessive disorder characterized by extreme sensitivity to ultraviolet radiation (UVR) from sunlight that results in a defective repair of DNA damage and, as a consequence, a marked predisposition to the development of cancer of the skin. Its clinical manifestations are photosensitivity, pigmentary skin changes, and premature aging of the skin. This disorder affects approximately 1 in 250,000 individuals per year in the United States. We present the case of a 12-year-old patient with Xeroderma Pigmentosum detected at 6 months of age, who developed an ulcerated lesion on the left nasal slope with a pathology report of angiosarcoma (AS), which we positive for ERG, CD31, and CD34. The patient was treated with wide resection of the lesion and adjuvant chemotherapy with paclitaxel and doxorubicin without radiation therapy.


Subject(s)
Male , Child , Skin Neoplasms , Xeroderma Pigmentosum , Radiotherapy , Skin , Chemotherapy, Adjuvant , Hemangiosarcoma
6.
Rev. cir. (Impr.) ; 74(1): 61-72, feb. 2022. tab, ilus
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1388920

ABSTRACT

Resumen Introducción: Los aloinjerto cutáneos (AC) son excelentes sustitutos cutáneos temporales, sin embargo, la donación y procura de piel cadavérica, fuente habitual de AC, es baja. Objetivo: Evaluar la factibilidad de utilizar la piel proveniente de abdominoplastías como fuente de AC y su eficacia clínica. Materiales y Método: Entre el 17 de agosto de 2020 al 28 de febrero de 2021 se analizó una cohorte prospectiva de 14 pacientes femeninas sometidas a abdominoplastía por motivos estéticos, que aceptaron donar la piel del colgajo cutáneo abdominal redundante, la cual fue criopreservada. Se utilizaron los AC de piel total criopreservados (ACPTC) en 10 pacientes con diagnósticos de: pie diabético (4), laparostomía contenida (2) herida compleja extremidad inferior (2), sarcoma de cuero cabelludo recidivado (1) y melanoma (1). Resultados: Se obtuvieron 14 colgajos de piel total, los cuales fueron procesados obteniendo una superficie promedio de 302 cm2 y 8,3 láminas de distintos tamaños de utilidad clínica por paciente. En todos los pacientes en que se utilizó ACPTC hubo un prendimiento inicial del AC para posteriormente, en promedio 21 días, presentar una escara necrótica que al ser retirada presentaba un tejido vital adherido al receptor rico en fibroblastos, siendo algunos pacientes auto injertados y otros manejados con cicatrización por segunda intención como tratamiento definitivo. Discusión: Los ACPTC proporcionan una cobertura intermedia, pues una parte se integra en forma definitiva, actuando como un andamiaje biológico para la formación de una interfase sobre la cual se puede autoinjertar o dejar evolucionar con cicatrización por segunda intención y una parte es rechazada. Conclusión: La procura de piel de donante vivo, en pacientes sometidos a cirugías de contorno corporal es un proceso factible, fuente de ACPTC, los cuales permiten una nueva cobertura intermedia con múltiples aplicaciones clínicas.


Introduction: Skin allografts (SA) are outstanding temporary skin substitutes; however, cadaveric skin donation and procurement, a common source of SA, remains low. Aim: To evaluate the feasibility and clinical efficacy of using skin from abdominoplasties as a source of SA. Materials and Method: A prospective cohort was analyzed from August 17th, 2020 and February 28th, 2021, with 14 female patients submitted to abdominoplasty surgeries for aesthetic motives, who authorized skin donation from the redundant abdominal flap which was posteriorly cryopreserved. Cryopreserved total skin allografts (CTSA) was used in 10 patients with the following diagnoses: diabetic foot (4), contained laparostomy (2) complex wound of the lower limb (2), relapsing sarcoma of the scalp (1), and melanoma (1). Results: 14 CTSA were obtained, which were processed, obtaining an average area of 302 cm2 and 8.3 sheets of different sizes and clinical applications from each patient. In all patients who received CTSA, an initial attachment was observed, followed by the appearance of a necrotic scar in an average of21 days. The peeling of the latter revealed a vital tissue tightly adhered to the receptor and rich in fibroblasts. Some of the patients received autografts, and others were managed with secondary intention scarring as a definite treatment. Discussion: CTSA provide an intermediate coverage since one part is definitely adhered to, acting as a biologic scaffolding for the formation of an interface that can be autografted or left for a secondary intention scarring, and the host rejects the other portion. Conclusión: skin procurement from a living donor in patients submitted to body contour surgeries is a feasible process and significant source of CTSA, which permits a new intermediate coverage with multiple clinical uses.


Subject(s)
Humans , Female , Cryopreservation , Abdominoplasty/methods , Allografts/surgery , Skin , Medical Examination , Surveys and Questionnaires , Informed Consent
8.
An. bras. dermatol ; 97(1): 93-95, Jan.-Feb. 2022. graf
Article in English | LILACS | ID: biblio-1360086

ABSTRACT

Abstract Jorge Lobo's disease (JLD) is a chronic, granulomatous fungal infection caused by the traumatic implantation of the fungus Lacazia loboi in the cutaneous and subcutaneous tissues, with the presence of isolated nodular and coalescent keloidal lesions. Malignant degeneration is rare. This case report describes a 64-year-old male patient with JLD for 30-years who showed a change in the aspect of a lesion in the left lower limb. Histopathological examination confirmed the progression to well-differentiated squamous cell carcinoma (SSC). JLD is highly prevalent in tropical and subtropical regions, requiring monitoring concerning the transformation into SSC in long-term lesions.


Subject(s)
Humans , Male , Carcinoma, Squamous Cell , Lacazia , Lobomycosis , Skin , Middle Aged
9.
Braz. J. Vet. Res. Anim. Sci. (Online) ; 59: e190524, fev. 2022. tab
Article in English | LILACS, VETINDEX | ID: biblio-1380228

ABSTRACT

Leishmaniases comprise a spectrum of diseases caused by protozoan parasites of the genus Leishmania, with some species of rodents being incriminated as reservoirs. The capybara is the largest extant rodent species in the world and is widely distributed in South America. The occurrence of infection by Leishmania spp. was investigated in capybaras captured in Brazil during 2015­2019 from established populations in five highly anthropic areas of the state of São Paulo and two natural areas of the states of Mato Grosso and Mato Grosso do Sul. A total of 186 individuals were captured and subjected to abdominal skin biopsy. All skin samples were Leishmania kDNA-negative, suggesting that capybaras have no role in the transmission cycles of Leishmania species in the studied areas despite the well-known role of other rodents in the life cycle of Leishmania spp.(AU)


As leishmanioses compreendem um espectro de doenças causadas por protozoários do gênero Leishmania e algumas espécies de roedores são incriminadas como reservatórios de Leishmania spp. As capivaras compreendem a maior espécie de roedores existentes e são amplamente distribuídas na América do Sul. Para investigar a ocorrência de infecção por Leishmania spp. em capivaras, durante os anos de 2015-2019 capivaras foram capturadas em cinco áreas antrópicas do estado de São Paulo e em duas áreas naturais dos estados do Mato Grosso e do Mato Grosso do Sul, todos esses ambientes com populações de capivaras estabelecidas. Um total de 186 indivíduos foram capturados e submetidos à biópsia de pele abdominal. Todas as amostras de pele foram negativas para o alvo kDNA, assim, os dados sugerem que nas áreas estudadas as capivaras não têm papel no ciclo de transmissão de espécies de Leishmania spp., apesar do papel bem conhecido de outros roedores no ciclo de vida de Leishmania spp.(AU)


Subject(s)
Animals , Protozoan Infections, Animal/diagnosis , Rodentia/microbiology , Leishmaniasis/diagnosis , Skin/microbiology , Biopsy/instrumentation , Brazil , DNA, Kinetoplast/analysis , Leishmania/genetics
10.
Arch. argent. pediatr ; 120(1): e34-e38, feb 2022. tab, ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-1353770

ABSTRACT

Los xantomas cutáneos reflejan el depósito de lípidos en la piel y pueden ser la única manifestación temprana de dislipidemias de inicio en la infancia. Las características y distribución de los xantomas orientan a la patología de base; los xantomas tuberosos tienen una fuerte asociación con la hipercolesterolemia homocigota familiar, una patología muy infrecuente. Su detección temprana otorga una ventana terapéutica para prevenir la ateroesclerosis acelerada y la mortalidad. Se presenta el caso de una paciente que comenzó a los dos años con xantomas tuberosos, que fueron la clave diagnóstica para identificar la hipercolesterolemia homocigota familiar subyacente.


Cutaneous xanthomas reflect lipid deposition on the skin and may be the only early manifestation of a childhoodonset dyslipidemia. Characteristics and distribution of the xanthomas signalize the underlying pathology, tuberousxanthomas being strongly associated with homozygous familial hypercholesterolaemia, an extremely rare condition. Its early detection provides a therapeutic window to prevent accelerated atherosclerosis and mortality. We present the case of a patient who started at two years with tuberous xanthomas, which were the diagnostic clue to identify the underlying homozygous familial hypercholesterolaemia.


Subject(s)
Humans , Female , Child, Preschool , Xanthomatosis/diagnosis , Xanthomatosis/etiology , Xanthomatosis/drug therapy , Dyslipidemias , Hypercholesterolemia , Skin , Early Diagnosis
11.
An. bras. dermatol ; 97(1): 14-21, Jan.-Feb. 2022. tab
Article in English | LILACS | ID: biblio-1360096

ABSTRACT

Abstract Background: Mucocutaneous adverse events are common during anticancer treatment, with variable consequences for the patient and their therapeutic regimen. Objective: To evaluate the most common adverse events, as well as the drugs associated with their appearance and the consequences for cancer treatment. Methods: A retrospective study was carried out through the analysis of patients treated at the Clinical Dermatology Unit of a public oncologic hospital. Results: A total of 138 patients with 200 adverse events were evaluated. The most commonly identified adverse events were nail and periungual changes (20%), papulopustular eruptions (13%), acneiform eruptions (12%), hand-foot syndrome (6.5%), hand-foot skin reaction (6%), and xerosis (6%). The most frequently associated antineoplastic treatment groups were classical chemotherapy (46.2%), target therapy (32.3%), and other non-antineoplastic drugs used in neoplasia protocols (16.5%). Of the total number of patients, 17.4% had their treatment suspended or changed due to a dermatological adverse event. Study limitations: Retrospective study and analysis of patients who were referred for specialized dermatological examination only, not allowing the assessment of the actual incidence of adverse events. Conclusion: A wide variety of dermatological manifestations are secondary to antineoplastic treatment with several different drugs resulting, not rarely, in the interruption or modification of therapeutic regimens.


Subject(s)
Humans , Neoplasms/drug therapy , Antineoplastic Agents/adverse effects , Skin , Retrospective Studies , Hospitals
12.
Rev. méd. Chile ; 150(1): 88-92, ene. 2022. ilus
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1389622

ABSTRACT

D. Julius was awarded the 2021 Medicine Nobel prize for the discovery of new cationic channels that detect temperatures either over 40 °C (TRPV1) or cold (TRPM8) ranging from 8-15 °C, followed by the latter identification of other channels that sense temperatures within other ranges. On the other hand, A. Patapoutian shared the 2021 Nobel prize for the independent and simultaneous co-discovery of the TRPM8 cationic channel. Furthermore, Patapoutian iden-tified piezo 1 and 2 channels previously referred to as the cell mechanosensors related to the sense of touch and proprioception. These experimental findings indicate that these novel cationic channels localized in nerve endings of the skin, mouth, lips, bronchial tree, the nephron, plus a variety of tissues transduce phy-sical stimuli into electrical activity that reach the brain sensory cortex to process these stimuli and elicit animal behavior.


Subject(s)
Animals , TRPM Cation Channels/physiology , Skin , Temperature , Cold Temperature , Nobel Prize
13.
Rev. cienc. salud (Bogotá) ; 20(1): 1-7, ene.-abr. 2022. ilus
Article in Spanish | LILACS, COLNAL | ID: biblio-1367571

ABSTRACT

Introducción: la endometriosis es una de las patologías ginecológicas más frecuentes, que se entiende como la implantación intrapélvica de tejido endometrial, sensible, en la gran mayoría de casos, al influjo hormonal. Extrauterinamente, se caracteriza por la presencia de glándulas y estroma endometrial en órganos o tejidos no ginecológicos. Sin embargo, la piel corresponde a uno de los sitios con menor fre-cuencia de implantación, ya sea de forma primaria o secundaria. Se calcula la incidencia de endometrio-sis cutánea en la zona umbilical en menos del 1 % de los casos. Presentación del caso: mujer de 36 años de edad, quien consulta con Cirugía General por un cuadro clínico de dos años de evolución, consistente en lesiones sobrelevantadas de la piel en la región umbilical, de color café oscuro, las cuales describe como dolorosas y sangrantes en el momento del ciclo menstrual. A pesar de haber sido resecadas en dos ocasiones, se encontró persistencia del cuadro. Discusión: la endometriosis cutánea primaria umbilical representa del 0.5 al 1.0 % de todas las pacientes con endometriosis ectópica, y el ombligo es uno de los sitios menos comunes de implantación. Esta condición afecta alrededor del 5 al 15 % de mujeres en edad fértil, y del 3 al 5 % de mujeres en edad menopaúsica. La presentación clínica más común se basa en una masa palpable, sangrado umbilical y dolor regular o irregular abdominal. Al asociar la endometriosis extrapélvica con la presencia de endometriosis pélvica, solamente alrededor del 20 % de las pacientes presentará esta última


Introduction: Endometriosis is one of the most frequent gynecological pathologies, understood as an intrapelvic implantation of endometrial tissue, sensitive to hormonal influence in most cases. At the extrauterine level, it is characterized by the presence of endometrial glands and stroma in the non-gy-necological organs or tissues. However, the skin corresponds to one of the sites with the least frequency of implantation, either primary or secondary, with the incidence of cutaneous endometriosis being calculated at the umbilical level in <1% of the cases. Case presentation: A 36-year-old female patient presented to the General Surgery department with a two-year history of dark brown, raised skin lesions in the umbilical region, which she described as painful, and bleeding at the time of the menstrual cycle. Despite having been resected twice, the condition still persisted. Discussion: Umbilical primary cutane-ous endometriosis represents 0.5%­1.0% of all patients with ectopic endometriosis, with the navel being one of the least common implantation sites. This condition affects about 5%−15% of women of childbear-ing age, and 3%−5% women of menopausal age. The most common clinical presentation is based on the palpable mass, umbilical bleeding, regular or irregular abdominal pain. Associating extrapelvic endo-metriosis with the presence of pelvic endometriosis, only about 20% of the patients will have the latter


Introdução: a endometriose é uma das patologias ginecológicas mais frequentes, entendida como o implante intrapélvico de tecido endometrial, sensível na grande maioria dos casos à influência hor-monal. No nível extrauterino, é caracterizada pela presença de glândulas e estroma endometriais em órgãos ou tecidos não ginecológicos. Porém, a pele corresponde a um dos locais com menor frequência de implantação, seja ela primária ou secundária, calculando-se a incidência de endometriose cutânea ao nível umbilical em menos de 1% dos casos. Apresentação do caso: paciente do sexo feminino, com 36 anos de idade, que consulta para Cirurgia Geral devido a quadro clínico de 2 anos de evolução, cons-tituído por lesões cutâneas elevadas na região umbilical, de coloração marrom-escura, que descreve como dolorosas e com sangramento no momento do ciclo menstrual. Apesar de ter sido ressecado em 2 ocasiões, o quadro era persistente. Discussão: a endometriose cutânea primária umbilical representa 0.5%-1.0% de todas as pacientes com endometriose ectópica, sendo o umbigo um dos locais de implan-tação menos comuns. Essa condição afeta cerca de 5% a 15% das mulheres em idade reprodutiva e 3% a 5% das mulheres em menopausa. A apresentação clínica mais comum baseia-se em massa palpável, sangramento umbilical, dor abdominal regular ou irregular. Ao associar a endometriose extrapélvica à presença de endometriose pélvica, apenas cerca de 20% das pacientes a apresentarão


Subject(s)
Humans , Female , Adult , Endometriosis , Skin , General Surgery , Umbilicus , Incidence
14.
São Paulo; s.n; s.n; 2022. 172 p. tab, graf.
Thesis in English | LILACS | ID: biblio-1378625

ABSTRACT

The solar ultraviolet (UV) radiation that reaches the Earth is composed of 95% of UVA (320 to 400 nm) and 5% of UVB (280 to 320 nm) radiation. UVB is carcinogenic, generating potentially mutagenic DNA lesions. The solar UVA radiation also causes DNA damage, but this fact does not fully account for its biological impact. UVA is absorbed by non-DNA cellular chromophores, generating reactive oxygen species such as singlet oxygen. Knowing the proteome mediates stress responses in cells, here we investigated the cellular effects of a non-cytotoxic dose of UVA radiation, equivalent to about 20 minutes of midday sun exposure, on the proteome of human keratinocytes. Using a combination of mass spectrometry-based proteomics, bioinformatics, and conventional biochemical assays, we analyzed two aspects of UVA-induced stress: spatial remodeling of the proteome in subcellular compartments 30 minutes after stress and long-term changes in protein levels and secretion (24 hours and 7 days postirradiation). In the first part of this thesis, we quantified and assigned subcellular localization for over 3000 proteins, of which about 600 potentially redistribute upon UVA exposure. Protein redistributions were accompanied by redox modulations, mitochondrial fragmentation and DNA damage. In the second part of the work, our results showed that primary human keratinocytes enter senescence upon exposure to a single dose of UVA, mounting antioxidant and inflammatory responses. Cells under UVA-induced senescence further elicit paracrine responses in neighboring premalignant HaCaT epithelial cells via inflammatory mediators. Altogether, these results reiterate the role of UVA radiation as a potent metabolic stressor in the skin


A radiação ultravioleta (UV) solar que atinge a superfície terrestre é composta por 95% de radiação UVA (320 a 400 nm) e 5% de radiação UVB (280 a 320 nm). A radiação UVB é carcinogênica e gera lesões potencialmente mutagênicas no DNA. A radiação UVA solar também gera danos no DNA, mas a genotoxicidade dessa radiação não explica inteiramente o seu impacto biológico. Atualmente, sabe-se que a radiação UVA é absorvida por cromóforos celulares, gerando espécies reativas de oxigênio, como o oxigênio singlete. Sabendo que o proteoma é um mediador de respostas ao estresse celular, nós investigamos os efeitos celulares de uma dose não-citotóxica de radiação UVA, equivalente a cerca de 20 minutos de exposição ao sol, no proteoma de queratinócitos humanos. Utilizando espectrometria de massas, bioinformática e ensaios bioquímicos convencionais, nós analisamos dois aspectos do estresse induzido por radiação UVA: o remodelamento espacial do proteoma 30 minutos depois do estresse e alterações nos níveis e na secreção de proteínas no longo prazo (24 horas e 7 dias depois da irradiação). Na primeira parte desta tese, nós quantificamos e atribuímos classificações de localização subcelular a mais de 3000 proteínas. Dentre essas proteínas, 600 tem potencialmente a sua distribuição subcelular alterada em resposta à radiação. As redistribuições subcelulares são acompanhadas de modulações redox, fragmentação mitocondrial e danos no DNA. Na segunda parte da tese, os nossos resultados mostraram que queratinócitos humanos primários entram em senescência sob exposição a uma única dose de radiação UVA, montando respostas antioxidantes e pró-inflamatórias. Células sob senescência induzida por UVA, por sua vez, desencadeiam respostas parácrinas em queratinócitos pré-tumorais (células HaCaT) por meio de mediadores inflamatórios. Em conjunto, esses resultados reiteram o papel da radiação UVA como um potente estressor metabólico em células da pele


Subject(s)
Skin , Ultraviolet Rays/adverse effects , Keratinocytes/chemistry , Proteomics/classification , Radiation Dosage , Mass Spectrometry/methods , DNA , Epithelial Cells/classification , Genotoxicity/adverse effects , HaCaT Cells/classification , Antioxidants/adverse effects
15.
São Paulo; s.n; s.n; 2022. 87 p. tab, graf, ilus.
Thesis in Portuguese | LILACS | ID: biblio-1379165

ABSTRACT

Um dos principais grupos de conservantes utilizados na maioria dos cosméticos são os parabenos que em muitos estudos demonstraram que podem provocar reações alérgicas como dermatite de contato, entre outras sensibilizações cutâneas. A fim de minimizar esses problemas, a indústria está produzindo cosméticos livres de conservantes ou de origem natural e em associações aos sintéticos. Dentre os conservantes naturais utilizados, podemos citar os óleos essenciais como uma alternativa viável. Diante deste contexto o presente trabalho visa avaliar experimentalmente o potencial antimicrobiano do óleo essencial de Conobea scoparioides Cham. & Schltdl., conhecida popularmente como pataqueira, o efeito de sua associação com parabenos e de sua eficácia como conservante em bases cosméticas. A composição do óleo essencial foi avaliada, indicando que este é composto em sua maior parte por terpenos, tendo éter metílico do timol (39,2%), timol (33,8 %) e α-felandreno (15,9%) como compostos majoritários. A atividade antimicrobiana do óleo essencial e do timol foi acessada através da concentração inibitória mínima (CIM), cujos resultados em µg/mL para o óleo essencial e o timol foram respectivamente: Staphylococcus aureus 650,70 e 284,90, Escherichia coli 721,53 e 271,20, Pseudomonas aeruginosa 1748,00 e > 2.000, Burkholderia cepacia 833,03 e 1.077,70, Candida albicans 521,43 e 172,61 e Aspergillus brasiliensis 300 e 400. O efeito sinérgico da associação do óleo essencial com os parabenos foi realizado através de um delineamento experimental centroide simplex para uma mistura de metilparabeno, propilparabeno e óleo essencial frente aos mesmos micro-organismos utilizados na determinação da atividade antimicrobiana. As concentrações ideais obtidas pela análise estatística para cada componente em µg/mL foram: 1120 para o metilparabeno, 350 para o propilparabeno e 675 para o óleo essencial. O teste de eficácia do sistema conservante em formulação cosmética foi efetuado empregando as concentrações ideais e mais duas concentrações superiores e uma abaixo do ideal. Para todas as cepas microbianas desafiadas o resultado do teste foi de redução total da carga microbiana inoculada nos sete dias de ensaio e nenhum aumento até o vigésimo oitavo dia o que demonstra a eficácia da associação do óleo essencial com os conservantes sintéticos. O óleo essencial de C. scoparioides apresentou um potencial antimicrobiano importante tanto sozinho como em associação com conservantes sintéticos. Estes resultados sugerem que esse óleo pode ser usado para compor um sistema conservante para formulações cosméticas contendo uma menor quantidade de sintéticos


One of the main groups of preservatives used in most cosmetics are parabens, that many studies have shown that they can cause allergic reactions such as contact dermatitis, among other skin sensitizations. To minimize these problems, the industry is producing cosmetics preservative free or using natural products instead and their combination with the synthetics. Among the natural preservatives used, we can mention essential oils as a viable alternative. In this context, the present work aims to experimentally evaluate the antimicrobial potential of the Conobea scoparioides Cham. & Schltdl. essential oil, popularly known as pataqueira, the effect of its association with parabens and its effectiveness as a preservative in cosmetic bases. The essential oil composition was analyzed, indicating that it is composed mostly of terpenes, with thymol methyl ether (39.2%), thymol (33.8%) and -phelandrene (15.9%) as major compounds. The antimicrobial activity of essential oil and thymol was accessed through the minimum inhibitory concentration (MIC), whose results in µg/mL for essential oil and thymol were respectively: Staphylococcus aureus 650.70 and 284.90, Escherichia coli 721, 53 and 271.20, Pseudomonas aeruginosa 1748.00 and > 2,000, Burkholderia cepacia 833.03 and 1,077.70, Candida albicans 521.43 and 172.61 and Aspergillus brasiliensis 300 and 400. The synergistic effect of the association of essential oil with parabens was performed through a centroid simplex experimental design for a mixture of methylparaben, propylparaben and essential oil against the same microorganisms used in the antimicrobial activity evaluation The ideal concentrations obtained by statistical analysis for each component in µg/mL were: 1120 for methylparaben, 350 for propylparaben and 675 for essential oil. The effectiveness test of the preservative system in cosmetic formulation was carried out using the ideal concentrations plus two higher concentrations and one below the ideal. For all challenged microbial strains, the test result was a total reduction of the inoculated microbial load in the seven days of testing and no increase until the twenty-eighth day, which demonstrates the effectiveness of the association of essential oil with synthetic preservatives. C. scoparioides essential oil showed an important antimicrobial potential both alone and in association with parabens. These results demonstrated that it can be used to compose a preservative system for cosmetic formulations containing lower amounts of synthetics


Subject(s)
Aspergillus/classification , Oils, Volatile/analysis , Cosmetics , Plantaginaceae/classification , Parabens/pharmacology , Skin , Burkholderia cepacia/classification , Additives in Cosmetics , Anti-Infective Agents/adverse effects
16.
São Paulo; s.n; s.n; 2022. 157 p. tab, graf, ilus.
Thesis in English | LILACS | ID: biblio-1380998

ABSTRACT

Melanoma accounts for 3% of skin neoplasms and is the leading cause of death from skin disorders worldwide. The high mortality rate associated with this disease stems from the high capacity of melanoma patients to develop metastases and treatment relapse with inhibitors of the MAPK signaling pathway (such as BRAF inhibitors), commonly used in melanoma therapy. Thus, the investigation of genes involved in the mechanisms of melanoma development is essential for new and more effective therapeutic strategies. Hence, we describe in this thesis two projects involving the genes SIN3B and IRF4 as possible biomarkers for cutaneous melanoma. Initially, through bioinformatics analyses performed by our group, an upregulation of SIN3B was found in metastatic melanomas. This result together with the understanding of SIN3B role in regulating gene expression and oncogenic transformation, prompted us to describe in this thesis some mechanisms by which SIN3B may influence melanoma development. We then sought to characterize the gene function using SIN3B-deleted cells, generated by the CRISPR-Cas9 methodology. Initially, we observed increased SIN3B expression in BRAF-mutant metastatic melanomas, where we noted that the long splicing variant of the gene (NM_001297595.1) was effectively prevalent in melanomas. Subsequently, we designed gRNAs between the exons 2 and 3 of the human SIN3B gene and engineered three knockout clones and three control clones (containing empty lentiCRISPRv2 plasmid) from different melanoma cell lines (SKMEL28, A2058, and A375). Through functional analyses, it was observed that the absence of the gene did not interfere in the proliferation of tumor cells; however, it led to a decrease in invasive properties. These results were verified by Boyden chamber assays and transcriptome analysis (total RNA sequencing of deleted cells), where a decrease in migration and motility pathways was observed. Additionally, a screening of synthetically lethal genes with SIN3B was performed with a genome wide CRISPR library. These results showed that USP7 and STK11 genes, which belong to the FoxO signaling pathway, were essential in SIN3B-depleted melanoma cells. Finally, through a collaborative project with the Wellcome Trust Sanger Institute, previous large-scale sequencing analyses demonstrated that deletion of the IRF4 gene was lethal for melanoma cells. Accordingly, we performed IRF4 silencing in vitro and noticed that the lack of IRF4 promotes cell death and apoptosis, independently of MYC and MITF, known in the literature to be downstream targets of this gene. Therefore, these data suggest that IRF4 plays a vital role in melanoma cell survival. Taken together, both works herein described in this thesis demonstrate how CRISPR-Cas9 can be applied to study the functions and mechanisms of genes involved in melanoma progression, collectively helping in the development of more effective therapeutic strategies for this tumor


O melanoma representa 3% dos tipos de neoplasias cutâneas e é a maior causa das mortes por distúrbios de pele no mundo. A alta taxa de mortalidade associada à essa doença advém da alta capacidade de pacientes com melanoma desenvolverem metástases, e apresentarem recidiva após tratamento com inibidores da via de sinalização MAPK (como da proteína BRAF), comumente utilizados no tratamento de pacientes metastáticos. Assim, a investigação de genes envolvidos nos mecanismos de desenvolvimento do melanoma é primordial para novas estratégias terapêuticas mais efetivas. Dessa forma, descrevemos no presente trabalho dois projetos envolvendo os genes SIN3B e IRF4 como possíveis biomarcadores para melanoma cutâneo. Em análises prévias de bioinformática realizados pelo nosso grupo, SIN3B foi identificado tendo maior expressão em melanomas metastáticos. Além disso, diversos estudos mostraram que o gene está envolvido na regulação da expressão gênica e transformação oncogênica. Dessa forma, descrevemos nessa tese alguns mecanismos pelos quais SIN3B pode influenciar no desenvolvimento do melanoma, através da caracterização funcional de células SIN3B-deletadas pela metodologia CRISPR-Cas9. Inicialmente, observamos aumento na expressão de SIN3B em melanomas metastáticos BRAF-mutados, onde notamos que a variante de splicing longa do gene (NM_001297595.1), era efetivamente prevalente em melanomas. Assim, desenhamos sequências de RNA guias entre os éxons 2 e 3 do gene SIN3B humano e, obtivemos três clones knockout e outros três clones controle (contendo plasmídeo vazio) em diferentes linhagens de melanoma (SKMEL28, A2058 e A375), para caracterização funcional. Observou-se que a ausência do gene não interferiu na proliferação das células tumorais, contudo, acarretou na diminuição de processos invasivos. Esses resultados foram averiguados através de ensaios em câmara de Boyden e análises de transcriptoma (sequenciamento de RNA total das células deletadas), onde notou-se diminuição das vias de migração e motilidade. Adicionalmente, um rastreamento de genes sinteticamente letais com SIN3B foi realizado com uma biblioteca de CRISPR capaz de silenciar todo o genoma. Esses resultados mostraram que os genes USP7 e STK11, ambos pertencentes à via de sinalização de FoxO, são essenciais nas células SIN3B deletadas. Por fim, através de um projeto colaborativo com o Wellcome Trust Sanger Institute, análises prévias de sequenciamento de larga escala demonstraram que a deleção do gene IRF4 era letal para células de melanoma. Dessa forma, realizamos o silenciamento de IRF4 in vitro e notamos que a ausência do gene promove morte celular e apoptose, independentemente de MYC e MITF, conhecidos na literatura por serem alvos downstream do gene. Portanto, esses dados sugerem que IRF4 tem um papel importante na sobrevivência de células de melanoma. Em conjunto, ambos trabalhos descritos nessa tese, demonstram como a metodologia CRISPR-Cas9 pode auxiliar no entendimento de processos importantes para a malignidade do melanoma e contribuir para estratégias terapêuticas mais efetivas para esse tumor


Subject(s)
Skin Neoplasms/complications , Methodology as a Subject , Melanoma/pathology , Neoplasm Metastasis , Neoplasms , Patients/classification , Skin , In Vitro Techniques/methods , Biomarkers/analysis , Gene Expression , Cell Survival , Sequence Analysis, RNA/instrumentation , Computational Biology/methods , Absenteeism , Clustered Regularly Interspaced Short Palindromic Repeats
17.
Braz. J. Pharm. Sci. (Online) ; 58: e18688, 2022. tab, graf
Article in English | LILACS | ID: biblio-1364425

ABSTRACT

Abstract Hydrogels are interesting for use in the treatment of topical wounds due to their virtually zero toxicity, and capacity for extended release of pharmaceuticals. Silver sulfadiazine (SSDZ) is the drug of choice in the treatment of skin burns. The aim of the study was to determine cytotoxicity, antimicrobial activity and stability of a PVA hydrogel with integrated silver sulfadiazine. SSDZ-hydrogels were prepared using 10% (w/w) PVA (either 89% or 99% hydrolyzed) and 1% (w/w) silver sulfadiazine. Cellular viability was assessed via MTS assays, antimicrobial activity via disk-diffusion and accelerated stability tests were carried out with analysis at 0, 30, 60, 90 and 180 days of storage at 40 ± 2 °C and a relative humidity of 75 ± 5%. The parameters evaluated included organoleptic characteristics, moisture, swelling ability, mechanical strength, FTIR, XRD, TGA and DSC, and silver release patterns via XRD and potentiometry. Cell viability tests indicated some cytotoxicity, although within acceptable levels. After 90 days of storage, SSDZ hydrogel samples exhibited a brown coloration, probably due to the formation of Ag or Ag2O nanoparticles. The SSDZ-loaded hydrogels suffered visual and physical changes; however, these changes did not compromise its use as occlusive wound dressings or its antimicrobial properties.


Subject(s)
Silver Sulfadiazine/pharmacology , Pharmaceutical Preparations/analysis , Hydrogels/analysis , Skin/injuries , Wounds and Injuries/classification , Spectroscopy, Fourier Transform Infrared , Reference Standards/classification
18.
Braz. J. Pharm. Sci. (Online) ; 58: e19664, 2022. tab
Article in English | LILACS | ID: biblio-1394033

ABSTRACT

Abstract Neonatal sepsis continues to be a major cause of morbidity and mortality worldwide. Coagulase-negative staphylococci (CoNS), commonly found on the skin, being the main agents isolated. The aim of this study was to evaluate CoNS isolated from blood cultures of newborn (NB) infants. The study took place between 2014 and 2016/2017 in a tertiary hospital in southern Brazil. Using the VITEK 2 system (bioMérieux, Marcy l'Etoile, France), the microorganisms were identified and had their sensitivity profiles determined. The minimum inhibitory concentrations of linezolid, tigecycline, and vancomycin were also determined. The clinical parameters and mortality rates of NBs were evaluated. From January to December 2014, 176 CoNS isolates were obtained from 131 patients and from June 2016 to July 2017, 120 CoNS isolates were obtained from 79 patients. Staphylococcus epidermidis was most prevalent in both periods. Resistance rates increased between 2014 and 2016/2017, especially against ciprofloxacin (52.27% and 73.11%, p = 0.0004), erythromycin (51.40% and 68.07%, p = 0.0054), gentamicin (50.59% and 67.23%, p = 0.0052), and penicillin (71.3% and 99.17%, p = 0.0001), respectively. With 100% susceptibility to linezolid, tigecycline, and vancomycin in both periods and methodologies tested. In 2014, 53.44% of the NBs received antibiotic therapy, and of these, 77.14% used a catheter; in 2016/2017, these were 78.48% and 95.16%, respectively. Regarding laboratory tests, a hemogram was ineffective, since patients with sepsis presented normal reference values. In 2014 and 2016/17, 15.71% and 17.74% of the NBs died, respectively. S. epidermidis was the predominant microorganism, related to catheter use in most cases. The resistance rates have increased over time, demonstrating the importance of adopting control and prevention measures in this hospital. CoNS are responsible for a significant neonatal sepsis mortality rate in infants.


Subject(s)
Humans , Male , Female , Infant, Newborn , Staphylococcal Scalded Skin Syndrome/pathology , Infant, Newborn , Coagulase/adverse effects , Skin , Staphylococcus epidermidis/pathogenicity , Microbial Sensitivity Tests/instrumentation , Mortality , Sepsis/pathology , Blood Culture/classification , Blood Culture/instrumentation , Hospitals
19.
Braz. J. Pharm. Sci. (Online) ; 58: e19426, 2022. tab, graf
Article in English | LILACS | ID: biblio-1383978

ABSTRACT

Abstract Bioequivalence (BE) assessment of topical drug products is a long-standing challenge. Agencies such as the Food and Drug Administration (FDA) and the European Medicines Agency (EMA) have published several drafts in recent years suggesting different approaches as alternative to evaluate the BE. A proposed Topical Classification System (TCS) has even been discussed. Given the above, the objective of this research was to use in vitro and in vivo BE approaches to evaluate Brazilian marketed mupirocin (MPC) ointments, previously classified as TCS class The in vitro permeation test (IVPT) was performed by applying formulations to pig skin by Franz cells. The in vivo methodology was dermatopharmacokinetic (DPK). These approaches (in vivo tape stripping and IVPT) demonstrated capability of distinguishing among different formulations, thus making them useful methodologies for BE evaluation.


Subject(s)
Ointments/analysis , In Vitro Techniques/methods , Therapeutic Equivalency , Mupirocin/analysis , Research/instrumentation , Skin , United States Food and Drug Administration , Pharmaceutical Preparations/analysis , Methodology as a Subject
20.
Braz. J. Pharm. Sci. (Online) ; 58: e191093, 2022. tab, graf
Article in English | LILACS | ID: biblio-1383999

ABSTRACT

Abstract In recent years, improvements have been made, through biotechnological processes, in the production and development of peptides capable of increasing collagen and elastin synthesis for anti-aging skin care. However, proteins have many limitations due to their structural, chemical and physical fragility to external aggressions, which may cause conformational changes, leading to loss of biological activity. Therefore, it is important to create delivery systems that protect these biomolecules from damage, allowing them to reach their target. This work aimed to develop a system able to carry bovine serum albumin (BSA), used as a model of a protein, and to incorporate this system in a semisolid formulation suitable for skin application. A microemulgel based on a solid-in-oil-in-water (S/O/W) microemulsion was prepared. Firstly, the association efficiency (AE) of lyophilized BSA-sucrose ester complex and the size of S/O nanodispersion were assessed; then, the characterization and stability evaluation of the final semisolid formulation through evaluation of pH, texture and rheological behavior were performed. The average value of AE was 54.74% ± 2.17. It was possible to develop an S/O/W microemulsion, which allowed the subsequent development of an S/O/W microemulgel that assured suitable pH, texture and rheological characteristics for skin application.


Subject(s)
Serum Albumin, Bovine , Proteins/adverse effects , Collagen , Peptides/agonists , Skin/drug effects , Biological Products , Aging , Hydrogen-Ion Concentration
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