Liver resection and ablation for squamous cell carcinoma liver metastases.

BACKGROUND: Limited evidence exists to guide the management of patients with liver metastases from squamous cell carcinoma (SCC). The aim of this retrospective multicentre cohort study was to describe patterns of disease recurrence after liver resection/ablation for SCC liver metastases and factors associated with recurrence-free survival (RFS) and overall survival (OS). METHOD: Members of the European-African Hepato-Pancreato-Biliary Association were invited to include all consecutive patients undergoing liver resection/ablation for SCC liver metastases between 2002 and 2019. Patient, tumour and perioperative characteristics were analysed with regard to RFS and OS. RESULTS: Among the 102 patients included from 24 European centres, 56 patients had anal cancer, and 46 patients had SCC from other origin. RFS in patients with anal cancer and non-anal cancer was 16 and 9 months, respectively (P = 0.134). A positive resection margin significantly influenced RFS for both anal cancer and non-anal cancer liver metastases (hazard ratio 6.82, 95 per cent c.i. 2.40 to 19.35, for the entire cohort). Median survival duration and 5-year OS rate among patients with anal cancer and non-anal cancer were 50 months and 45 per cent and 21 months and 25 per cent, respectively. For the entire cohort, only non-radical resection was associated with worse overall survival (hazard ratio 3.21, 95 per cent c.i. 1.24 to 8.30). CONCLUSION: Liver resection/ablation of liver metastases from SCC can result in long-term survival. Survival was superior in treated patients with liver metastases from anal versus non-anal cancer. A negative resection margin is paramount for acceptable outcome.

The potential of FT-IR spectroscopy for improving healthcare in sepsis - An animal model study.

Fourier Transform-Infrared (FT-IR) absorption spectroscopy has been used to investigate pathophysiological changes caused by sepsis. Sepsis has been defined as a potentially fatal organic dysfunction caused by a dysregulated host response to infection and can lead a patient to risk of death. This study used samples consisting of the blood plasma of mice which were induced to sepsis state, compared to a healthy group using FT-IR associated with attenuated total reflectance (ATR) spectroscopy. For statistical analysis, principal components analysis (PCA) and linear discriminant analysis (LDA) were applied, independently, to the second derivative spectra of both the fingerprint (900-1800 cm-1) and the high wavenumber (2800-3100 cm-1) regions. The technique efficiently differentiated the blood plasma of the two groups, sepsis and healthy mice, the analysis indicating that fatty acids and lipids in the blood samples could be an important biomarker of sepsis.

Short report - Herpes simplex lesion in the lip semimucosa in a COVID-19 patient.

OBJECTIVE: The present case report aims to make a discussion concerning oral manifestations in a patient with a confirmed diagnosis of COVID-19. Female patient, 20 years old, nursing technician, showed severe sore throat and headache without presence of fever. She tested positive for COVID-19 RT-PCR test in 2 episodes. She also showed lesions in the median lower lip semimucosa and severe pruritus, with a clinical course of 14 days, in which we performed a clinical diagnosis of herpes simplex infection. We need to be precise in terms of clinical appearance and possible relation with the disease, as the clinicians have access to the patients.

Vibration spectroscopy and body biofluids: Literature review for clinical applications.

Vibrational spectroscopy techniques such as Raman and IR (infrared) allow real-time, non-invasive and non-destructive analysis of organic compounds with a good limit-of-detection. This review aims to show the progress of clinical diagnosis and prognosis due to advances of vibrational spectroscopy techniques in biofluids through an extensive literature review. This review was performed by searching for studies using the keywords "biofluids or biological fluids" and "diagnostic techniques" in PubMed, Scopus and Google Scholar. We found 580 articles in the 1990s, 1171 articles in the 2000s and 1688 in the years from 2011. Also, a second search including "biofluids or biological fluids" and "vibrational spectroscopy" returned only one article in the 1990s, three papers in the 2000s and 18 in the years from 2011.This growth suggests a great potential of biofluid research using vibrational spectroscopy. Sample collection variations(quantity and contaminations due to contact with other body parts and their secretions) are important factors that influence sample composition. Once these factors are taken into account, spectroscopic analysis may provide the necessary information to identify a disease, lesion, tumor or infection. With the present review we aim to encourage the study of vibrational spectroscopy techniques for analysis of biofluids focusing in clinical applications. In the future, it will widely benefit clinicians, allowing new diagnostic approaches, and for patients to have early diagnosis for most every disease.

Simultaneous Parenchyma-Preserving Liver Resection, Cytoreductive Surgery and Intraperitoneal Chemotherapy for Stage IV Colorectal Cancer.

BACKGROUND: The outcome of stage IV colorectal cancer (CRC) has improved with modern systemic therapy. However, the concomitant presence of liver metastases (LM) and peritoneal carcinomatosis (PC) remains associated with a dismal prognosis and surgery in this context remains exceptional. METHODS: Stage IV CRC patients with LM and PC undergoing simultaneous cytoreductive surgery, intraperitoneal chemotherapy (IPC) and liver resection/ablation were identified from prospectively collected databases. We assessed response to neoadjuvant chemotherapy (NACT), postoperative complications, progression free survival (PFS), and overall survival (OS). RESULTS: Twenty-one patients with resectable disease were treated between 2007 and 2014. In 16 patients (76%), NACT was administered and tumour response defined their selection. The remaining 5 (24%) were selected according to the pattern of recurrence. Median peritoneal cancer index was 5 (range: 3-10.5). Liver surgery included 34 wedge resections, 5 ablations and one bisectionectomy to treat a total of 45 hepatic lesions with a median of 2 per patient (range: 1-2) and a median size of 1.35 cm (range: 0.8-2). Tumour regression grade 4 (fibrosis but residual cancer cells predominate) was seen in 50% of the resected metastases after NACT. Median hospital stay was 17 days (range: 14-24); severe morbidity (Clavien-Dindo grade 3-4) occurred in 24% and no perioperative mortality (0-90 days) was recorded. The median OS was 44 months (range: 31-57) while the median PFS was 10 months (range: 8-12). CONCLUSIONS: Combined parenchyma-preserving liver resection, cytoreductive surgery and IPC in patients with LM and PC from CRC can be performed safely and results in promising mid-term overall survival.

From conception to birth - how endometriosis affects the development of each stage of reproductive life.

Increasing evidence suggests that female infertility is associated with endometriosis. Indeed, 40% of women with this disease are infertile. However, a causal relationship has not yet been established, and the possible pathophysiology of infertility in this disease also has not been completely elucidated. In this article, we analyze the mechanisms necessary to achieve a successful live birth in patients with this disease as well as the important steps of fertility, pregnancy and birth that can be impaired in these women. Specifically, we will review new advances in research on folliculogenesis, oocyte quality and sperm quality, egg fertilization, embryo quality, transport through fallopian tube and utero-tubal transport sperm, implantation defects, risk of miscarriage, risk during pregnancy and pre-term delivery. The physiopathology of these alterations and the clinical results of the studies are still very controversial. For these reasons, we can conclude that more research is needed to study the biological pathways of the fertility impairment caused by this disease.

Excessive immunosuppression in kidney transplant patients: prevalence and outcomes.

BACKGROUND: Death with a functioning graft is currently one of the main causes of kidney graft loss. A large proportion of cases is attributed to infectious complications that can be related to overimmunosuppression. We retrospectively studied 80 kidney transplant patients, grafted from January 2005 to December 2009, to assess the prevalence of excessive immunosuppression, and its possible correlation with infections and infection-related death. METHODS: Excessive immunosuppression was defined by a prescribed dosage above the expected to the time point or an elevated drug blood level according to the Kidney Disease: Improving Global Outcomes (2009) recommendations at 1, 3, 6, and 12 months, and then annually. RESULTS: Death with a functioning graft accounted for 76.5% of losses. Overall, 53.8% of deaths were from infections, and 38.5% from cardiovascular causes. Acute rejection episodes were noted in 8.8% of patients. Only 10% of patients had adequate immunosuppression throughout the follow-up. Seventy-two percent of patients showed adequate immunosuppression at least half of the 18 evaluated points, although 50% showed between 1 and 3 drugs administered above recommended dosages during the whole period. Infections were recorded in 78.8% patients, with a median of 3 episodes per patient. Any level of excessive immunosuppression was associated with infections (odds ratio, 11.2; P < .001), but not with death caused thereby. CONCLUSION: Excessive immunosuppression among this cohort was associated with a greater incidence of infections, but not with death from this cause.

Kint3-4 promotes apoptosis and inhibition of angiogenesis in solid Ehrlich Tumor / Kint3-4 promove apoptose e inibição da angiogênese no tumor sólido de Ehrlich

A proteína Kint3-4 (PKint3-4), codificadora da angiostatina, é reconhecida por sua potencialidade antiangiogênica. O presente estudo teve como objetivo avaliar o efeito da proteína Kint3-4 no crescimento do tumor sólido de Ehrlich. Para isso, foram analisados a curva de desenvolvimento tumoral, o índice apoptótico e a dosagem de hemoglobina, a fim de se avaliar a angiogênese, em 20 camundongos Swiss fêmeas, inoculadas com o tumor sólido de Ehrlich em seus coxins plantares. Os resultados demonstraram a participação de PKint3-4 na indução à apoptose de células neoplásicas, na diminuição da concentração de hemoglobina e, principalmente, na diminuição do desenvolvimento tumoral. Sugere-se que a ação antitumoral, determinada pela sequência proteica utilizada, possa estar associada ao papel antiangiogênico da angiostatina, que indiretamente aumentaria o índice apoptótico das células neoplásicas, e/ou a uma ação direta da proteína Kint3-4 sobre essas células, estimulando-as a sofrerem apoptose.

Infecção experimental por Salmonella enterica subespécie enterica sorotipo Panama e tentativa de transmissão nasonasal em leitões desmamados / Experimental infection by Salmonella enterica ssp. enterica serovar Panama and tentative of nose-to-nose transmission in weaned pigs

O objetivo deste experimento foi produzir uma infecção experimental de Salmonella enterica subespécie. enterica sorotipo Panama e verificar a importância da via nasonasal na transmissão entre leitões desmamados. Foram utilizados seis leitões recém-desmamados, adquiridos de granja livre de Salmonella spp. Utilizaram-se baias isoladoras, que proporcionavam o contato nasonasal e eliminavam a possibilidade de outras vias de transmissão e de contaminação externa. Três grupos foram formados: controle, sentinela e infectado. Não foram encontradas amostras positivas para Salmonella spp. em leitões do grupo-controle e sentinelas, e nos animais infectados foi isolada Salmonella Panama em suabes retais e tecidos necropsiados. Os resultados revelaram não haver a transmissão pela via nasonasal entre leitões desmamados, pois, em nenhum momento, o agente foi isolado dos animais sentinelas.

Experimental infection of Salmonella enterica ssp. enterica serovars Panama was proceeded to establish the importance of nose-to-nose contact in the transmission among weaned pigs. Six recently-weaned pigs were acquired from a farm previously selected, free from Salmonella spp. Isolation stalls allowing nose-to-nose contact and eliminating other transmission routes as well outside contamination were used. Three groups were formed: control, sentinel, and infected. Piglets of control and sentinel groups were not positive for Salmonella spp., however, Salmonella Panama was isolated in infected animals in rectal swabs and necropsied tissues. It was concluded that there was not transmission by nose-to-nose contact among weaned pigs, since Samonella Panama was not isolated in the sentinel group at any moment.

Endometrioma de cicatriz após incisões cirúrgicas obstétricas: estudo retrospectivo de 33 casos e revisão de literatura / Scar endometrioma following obstetric surgical incisions: a retrospective study of 33 cases and literature review

Context and objetive:the incidence of scar endometrioma ranges from 0,03 to 3,5%. Certain factors relating to knowledge of the clinical history of the disease make correct diagnossi and treatment difficult. The aim here was to identify the clinical pattern of the disease and show surgicxal results. The literature on this topic was reviewed. Design and setting: retrospective study at hospital municipal municipal maternidade-escola dr. mário de moraes altenfelder silva. Methods: data from the medical records of patients with preoperative diagnoses of scar endometrioma who underwent operations between 2001 and 2007 were surveyed and reviewed. The postoperative diagnosis came from histopathological analysis. The main information surveyed was age, obstetric antecedents, symptoms, tumor location, size and palpation, duration of complaint, diagnosis and treatment. All patients underwent tumor excision with a safety margin. Results: there were 33 patients, of mean age 30,1+/- 5,0 years (range: 18-41 years). The total incidence was 0,11%: 0,29% in cesarean sections and 0,01% in vaginal deliveries. Twenty -nine tumors (87,9%) were located in cesarean scars, two (6,0%) in episiotomy scars and two (6,0%) in the umbilical region. the main symptom was localized cyclical pain (66,7%), of mean duration 30,5 months (+/-23). surgical treatment was successful in all cases. conclusion: this is an uncommon disease. the most important diagnostic characteristic is coincidence of painful syntoms with menstruation. patients undergoing cesarean section are at greatest risk: relative risk of 27,37 (p < 0,01). The surgical treatment of choice is excision of the endometrioma with a safety margin(au) - en