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1.
Sci Rep ; 14(1): 15662, 2024 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-38977836

RESUMO

Scincidae is one of the most species-rich and cosmopolitan clades of squamate reptiles. Abundant disarticulated fossil material has also been attributed to this group, however, no complete pre-Cenozoic crown-scincid specimens have been found. A specimen in Burmite (99 MYA) is the first fossil that can be unambiguously referred to this clade. Our analyses place it as nested within extant skinks, supported by the presence of compound osteoderms formed by articulated small ostedermites. The specimen has a combination of dorsal and ventral compound osteoderms and overlapping cycloid scales that is limited to skinks. We propose that this type of osteoderm evolved as a response to an increased overlap of scales, and to reduced stiffness of the dermal armour. Compound osteoderms could be a key innovation that facilitated diversification in this megadiverse family.


Assuntos
Âmbar , Fósseis , Animais , Fósseis/anatomia & histologia , Lagartos/anatomia & histologia , Filogenia , Evolução Biológica
2.
Ann R Coll Surg Engl ; 2024 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-38961733

RESUMO

Our aim was to investigate the effectiveness of navigated transcranial magnetic stimulation (nTMS) brain mapping to characterise preoperative motor impairment caused by an intradural extramedullary (IDEM) tumour and postoperative cortical functional reorganisation. Preoperative and 1-year follow-up clinical, radiological and nTMS data from a case of thoracic spinal meningioma that underwent surgical resection of the lesion were collected and compared. A 67-year-old patient presented with severe progressive thoracic myelopathy (hypertonic paraparesis, clonus, insensate urinary retention) secondary to an IDEM tumour. Initial nTMS assessment showed bilateral upper limb representation with no positive responses for both lower limbs. He underwent successful surgical resection for his IDEM (meningioma WHO grade 1). At 1-year follow-up, the patient's gait was improved and his bladder function normalised. nTMS documented positive responses for both upper and lower limbs and a decrease in the area (right side: 1.01 vs 0.39cm2; left side: 1.92 vs 0.81cm2) and volume (right side: 344.2 vs 42.4uVcm2; left side: 467.1 vs 119uVcm2) of cortical activation for both upper limbs, suggesting a functional reorganisation of the motor areas after tumour resection. nTMS motor mapping and derived metrics can characterise preoperative motor deficit and cortical plasticity during follow-up after IDEM resection.

3.
Cladistics ; 2024 May 04.
Artigo em Inglês | MEDLINE | ID: mdl-38703085

RESUMO

Biogeographic studies have generally relied on methods that use a few, large predefined areas, which may overlook fine-scale patterns. Here we test previous hypotheses about the biogeographic history of a diverse bat clade regarding its association with major Neotropical geological formations, particularly the Antilles, the South American Dry Diagonal, the Andes and the Panamanian land bridge, by applying a recently available method that uses actual distributions instead of predefined areas. We compiled and curated spatially explicit, georeferenced data of 173 bat species (Mammalia: Chiroptera: Noctilionoidea) from the online database Global Biodiversity Information Facility. By taking a previous comprehensive phylogeny as an evolutionary framework, we performed computationally intensive analyses using the Geographically-explicit Event Model. This method uses the observed species distributions to reconstruct the ancestral areas and biogeographic events at each phylogeny node. We found that sympatric speciation was the most frequently reconstructed event, and involved mainly the Panamanian Isthmus and northern South America (SA), but all sympatry reconstructions were different and specific to each node. Allopatric events were important in the Andes; vicariance caused both west/east and north/south disjunctions that went unnoticed previously. Founder events indicated bidirectional dispersal between the mainland and the Antilles since the Miocene, and across the incomplete Panamanian bridge and the SA Dry Diagonal since the early Pliocene. Overall, we found support for previous hypotheses on the influence of major Neotropical paleogeographic events in the diversification of the group, but additionally revealed multi-scale patterns that are embedded within the mainland and were previously overlooked. Our results highlight a trans-isthmian centre of diversification in the biogeographic history of Noctilionoidea including the Panamanian Isthmus and Northern SA.

4.
J Prev Alzheimers Dis ; 11(2): 414-421, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38374747

RESUMO

In vivo Alzheimer's disease diagnosis and staging is traditionally based on clinical features. However, the agreement between clinical and pathological Alzheimer's disease diagnosis, whose diagnosis assessment includes amyloid and Braak histopathological tau staging, is not completely convergent. The development of positron emission tomography (PET) tracers targeting neurofibrillary tangles offers prospects for advancing the staging of Alzheimer's disease from both biological and clinical perspectives. Recent advances in radiochemistry made it possible to apply the postmortem Braak staging framework to tau-PET images obtained in vivo. Here, our aim is to provide a narrative review of the current literature on the relationship between Alzheimer's disease clinical features and the PET-based Braak staging framework. Overall, the available studies support the stepwise increase in disease severity following the advance of PET-based Braak stages, with later stages being associated with worse cognitive and clinical symptoms. In line with this, there is a trend for unimpaired cognition, mild cognitive impairment, and Alzheimer's disease dementia to be compatible with early, intermediate, and late patterns of tau deposition based on PET-based Braak stages. Moreover, neuropsychiatric symptom severity seems to be linked to the extent of tau-PET signal across Braak areas. In sum, this framework seems to correspond well with the clinical progression of Alzheimer's disease, which is an indication of its potential utility in research and clinical practice, especially for detecting preclinical tau levels in individuals without symptoms. However, further research is needed to improve the generalizability of these findings and to better understand the applications of this staging framework.


Assuntos
Doença de Alzheimer , Disfunção Cognitiva , Humanos , Doença de Alzheimer/diagnóstico por imagem , Doença de Alzheimer/patologia , Proteínas tau , Emaranhados Neurofibrilares/patologia , Tomografia por Emissão de Pósitrons/métodos , Disfunção Cognitiva/diagnóstico por imagem , Disfunção Cognitiva/patologia
5.
Environ Res ; 242: 117735, 2024 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-38000630

RESUMO

Biogas methanation emerges as a prominent technology for converting biogas into biomethane in a single step. Furthermore, this technology can be implemented at biogas plant locations, supporting local economies and reducing dependence on large energy producers. However, there is a lack of comprehensive studies on biogas methanation, particularly regarding the technical optimization of operational parameters and the profitability analysis of the overall process. To address this gap, our study represents a seminal work on the technical optimization of biogas methanation obtaining an empirical model to predict the performance of biogas methanation. We investigate the influence of operational parameters, such as reaction temperature, H2/CO2 ratio, space velocity, and CO2 share in the biogas stream through an experimental design. Based on previous research we selected a nickel supported on ceria-alumina catalyst; being nickel a benchmark system for methanation process such selection permits a reliable data extrapolation to commercial units. We showcase the remarkable impact of studied key operation parameters, being the temperature, the most critical factor affecting the reaction performance (ca. 2 to 5 times higher than the second most influencing parameter). The impact of the H2/CO2 ratio is also noticeable. The response surfaces and contour maps suggest that a temperature between 350 and 450 °C and an H2/CO2 ratio between 2.5 and 3.2 optimize the reaction performance. Further experimental tests were performed for model validation and optimization leading to a reliable predictive model. Overall, this study provides validated equations for technology scaling-up and techno-economic analysis, thus representing a step ahead towards real-world applications for bio-methane production.


Assuntos
Biocombustíveis , Dióxido de Carbono , Níquel , Óxido de Alumínio , Biomassa
7.
PLoS Comput Biol ; 19(11): e1011673, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37992135

RESUMO

We analyzed a quantitative multiscale model that describes the epigenetic dynamics during the growth and evolution of an avascular tumor. A gene regulatory network (GRN) formed by a set of ten genes that are believed to play an important role in breast cancer development was kinetically coupled to the microenvironmental agents: glucose, estrogens, and oxygen. The dynamics of spontaneous mutations was described by a Yule-Furry master equation whose solution represents the probability that a given cell in the tissue undergoes a certain number of mutations at a given time. We assumed that the mutation rate is modified by a spatial gradient of nutrients. The tumor mass was simulated by means of cellular automata supplemented with a set of reaction diffusion equations that described the transport of microenvironmental agents. By analyzing the epigenetic state space described by the GRN dynamics, we found three attractors that were identified with cellular epigenetic states: normal, precancer and cancer. For two-dimensional (2D) and three-dimensional (3D) tumors we calculated the spatial distribution of the following quantities: (i) number of mutations, (ii) mutation of each gene and, (iii) phenotypes. Using estrogen as the principal microenvironmental agent that regulates cell proliferation process, we obtained tumor shapes for different values of estrogen consumption and supply rates. It was found that he majority of mutations occurred in cells that were located close to the 2D tumor perimeter or close to the 3D tumor surface. Also, it was found that the occurrence of different phenotypes in the tumor are controlled by estrogen concentration levels since they can change the individual cell threshold and gene expression levels. All results were consistently observed for 2D and 3D tumors.


Assuntos
Neoplasias da Mama , Humanos , Feminino , Neoplasias da Mama/genética , Neoplasias da Mama/metabolismo , Proliferação de Células/genética , Difusão , Separação Celular , Estrogênios
8.
Phys Rev E ; 107(6-1): 064134, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37464676

RESUMO

The standard Lipkin-Meshkov-Glick (LMG) model undergoes a second-order ground-state quantum phase transition (QPT) and an excited-state quantum phase transition (ESQPT). The inclusion of an anharmonic term in the LMG Hamiltonian gives rise to a second ESQPT that alters the static properties of the model [Gamito et al., Phys. Rev. E 106, 044125 (2022)2470-004510.1103/PhysRevE.106.044125]. In the present work, the dynamical implications associated to this new ESQPT are analyzed. For that purpose, a quantum quench protocol is defined on the system Hamiltonian that takes an initial state, usually the ground state, into a complex excited state that evolves on time. The impact of the new ESQPT on the time evolution of the survival probability and the local density of states after the quantum quench, as well as on the Loschmidt echoes and the microcanonical out-of-time-order correlator (OTOC) are discussed. The anharmonity-induced ESQPT, despite having a different physical origin, has dynamical consequences similar to those observed in the ESQPT already present in the standard LMG model.

9.
Int J Med Inform ; 177: 105163, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37517299

RESUMO

BACKGROUND: Timely care in the health sector is essential for the recovery of patients, and even more so in the case of a health emergency. In these cases, appropriate management of human and technical resources is essential. These are limited and must be mobilised in an optimal and efficient manner. OBJECTIVE: This paper analyses the use of the health emergency service in a city, Jaén, in the south of Spain. The study is focused on the most recurrent case in this service, respiratory diseases. METHODS: Machine Learning algorithms are used in which the input variables are multisource data and the target attribute is the prediction of the number of health emergency demands that will occur for a selected date. Health, social, economic, environmental, and geospatial data related to each of the emergency demands were integrated and related. Linear and nonlinear regression algorithms were used: support vector machine (SVM) with linear kernel and generated linear model (GLM), and the nonlinear SVM with Gaussian kernel. RESULTS: Predictive models of emergency demand due to respiratory disseases were generated with am absolute error better than 35 %. CONCLUSIONS: This model helps to make decisions on the efficient sizing of emergency health resources to manage and respond in the shortest possible time to patients with respiratory diseases requiring urgent care in the city of Jaén.


Assuntos
Serviços Médicos de Emergência , Doenças Respiratórias , Humanos , Algoritmos , Aprendizado de Máquina , Doenças Respiratórias/epidemiologia , Doenças Respiratórias/terapia , Máquina de Vetores de Suporte , Atenção à Saúde
10.
Front Bioeng Biotechnol ; 11: 1145550, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37362221

RESUMO

Sprouting angiogenesis is a core biological process critical to vascular development. Its accurate simulation, relevant to multiple facets of human health, is of broad, interdisciplinary appeal. This study presents an in-silico model replicating a microfluidic assay where endothelial cells sprout into a biomimetic extracellular matrix, specifically, a large-pore, low-concentration fibrin-based porous hydrogel, influenced by chemotactic factors. We introduce a novel approach by incorporating the extracellular matrix and chemotactic factor effects into a unified term using a single parameter, primarily focusing on modelling sprouting dynamics and morphology. This continuous model naturally describes chemotactic-induced sprouting with no need for additional rules. In addition, we extended our base model to account for matrix sensing and degradation, crucial aspects of angiogenesis. We validate our model via a hybrid in-silico experimental method, comparing the model predictions with experimental results derived from the microfluidic setup. Our results underscore the intricate relationship between the extracellular matrix structure and angiogenic sprouting, proposing a promising method for predicting the influence of the extracellular matrix on angiogenesis.

11.
Nucleic Acids Res ; 51(12): 5901-5910, 2023 07 07.
Artigo em Inglês | MEDLINE | ID: mdl-37224533

RESUMO

Although targeting TfR1 to deliver oligonucleotides to skeletal muscle has been demonstrated in rodents, effectiveness and pharmacokinetic/pharmacodynamic (PKPD) properties remained unknown in higher species. We developed antibody-oligonucleotide conjugates (AOCs) towards mice or monkeys utilizing anti-TfR1 monoclonal antibodies (αTfR1) conjugated to various classes of oligonucleotides (siRNA, ASOs and PMOs). αTfR1 AOCs delivered oligonucleotides to muscle tissue in both species. In mice, αTfR1 AOCs achieved a > 15-fold higher concentration to muscle tissue than unconjugated siRNA. A single dose of an αTfR1 conjugated to an siRNA against Ssb mRNA produced > 75% Ssb mRNA reduction in mice and monkeys, and mRNA silencing was greatest in skeletal and cardiac (striated) muscle with minimal to no activity in other major organs. In mice the EC50 for Ssb mRNA reduction in skeletal muscle was >75-fold less than in systemic tissues. Oligonucleotides conjugated to control antibodies or cholesterol produced no mRNA reduction or were 10-fold less potent, respectively. Tissue PKPD of AOCs demonstrated mRNA silencing activity primarily driven by receptor-mediated delivery in striated muscle for siRNA oligonucleotides. In mice, we show that AOC-mediated delivery is operable across various oligonucleotide modalities. AOC PKPD properties translated to higher species, providing promise for a new class of oligonucleotide therapeutics.


Assuntos
Oligonucleotídeos Antissenso , Oligonucleotídeos , Camundongos , Animais , Anticorpos/uso terapêutico , RNA Interferente Pequeno/genética , RNA Mensageiro/genética , Músculo Esquelético
12.
Annu Rev Phytopathol ; 61: 403-423, 2023 09 05.
Artigo em Inglês | MEDLINE | ID: mdl-37217203

RESUMO

Plant and soil microbiomes are integral to the health and productivity of plants and ecosystems, yet researchers struggle to identify microbiome characteristics important for providing beneficial outcomes. Network analysis offers a shift in analytical framework beyond "who is present" to the organization or patterns of coexistence between microbes within the microbiome. Because microbial phenotypes are often significantly impacted by coexisting populations, patterns of coexistence within microbiomes are likely to be especially important in predicting functional outcomes. Here, we provide an overview of the how and why of network analysis in microbiome research, highlighting the ways in which network analyses have provided novel insights into microbiome organization and functional capacities, the diverse network roles of different microbial populations, and the eco-evolutionary dynamics of plant and soil microbiomes.


Assuntos
Evolução Biológica , Microbiota , Organizações , Fenótipo , Solo
13.
Soft Matter ; 19(16): 2908-2918, 2023 Apr 26.
Artigo em Inglês | MEDLINE | ID: mdl-37006200

RESUMO

The process of fission and vesicle formation depends on the geometry of the membrane that will split. For instance, a flat surface finds it difficult to form vesicles because of the lack of curved regions where to start the process. Here we show that vesicle formation can be promoted by temperature, by using a membrane phase field model with Gaussian curvature. We find a phase transition between fluctuating and vesiculation phases that depends on temperature, spontaneous curvature, and the ratio between bending and Gaussian moduli. We analysed the energy dynamical behaviour of these processes and found that the main driving ingredient is the Gaussian energy term, although the curvature energy term usually helps with the process as well. We also found that the chemical potential can be used to investigate the temperature of the system. Finally we address how temperature changes the condition for spontaneous vesiculation for all geometries, making it happen in a wider range of values of the Gaussian modulus.

14.
Clin Oncol (R Coll Radiol) ; 35(5): e303-e311, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-36863956

RESUMO

AIMS: First-line FOLFIRINOX (FOLinic acid, Fluorouracil, IRINotecan, and OXaliplatin) and gemcitabine plus nab-paclitaxel (GnP) have been publicly funded for patients with unresectable locally advanced pancreatic cancer (uLAPC) in Ontario, Canada. We examined the overall survival and surgical resection rate after first-line FOLFIRINOX or GnP and determined the association between resection and overall survival in patients with uLAPC. MATERIALS AND METHODS: We conducted a retrospective population-based study including patients with uLAPC who received first-line treatment FOLFIRINOX or GnP from April 2015 to March 2019. The cohort was linked to administrative databases to ascertain demographic and clinical characteristics. Propensity score methods were used to balance differences between FOLFIRINOX and GnP. The Kaplan-Meier method was used to calculate overall survival. Cox regression was used to determine the association between receipt of treatment and overall survival, adjusting for time-dependent surgical resections. RESULTS: We identified 723 patients with uLAPC (mean age = 65.8, 43.5% female) who received FOLFIRINOX (55.2%) or GnP (44.8%). The median overall survival and 1-year overall survival probability were higher for FOLFIRINOX (13.7 months, 54.6%) than for GnP (8.7 months, 34.0%). Post-chemotherapy surgical resection occurred in 89 (12.3%) patients (FOLFIRINOX: 74 [18.5%] versus GnP: 15 [4.6%]), with no difference in survival since surgery between FOLFIRINOX and GnP (P = 0.29). After adjusting time-dependent post-treatment surgical resection, FOLFIRINOX (inverse probability treatment weighting hazard ratio 0.72, 95% confidence interval 0.61, 0.84) was independently associated with improved overall survival. CONCLUSIONS: In this real-world population-based study of patients with uLAPC, FOLFIRINOX was associated with improved survival and higher resection rates. FOLFIRINOX was associated with improved survival in patients with uLAPC after accounting for the effect of post-chemotherapy surgical resection, suggesting the benefit of FOLFIRINOX was not solely due to improving resectability.


Assuntos
Gencitabina , Neoplasias Pancreáticas , Humanos , Feminino , Masculino , Irinotecano , Oxaliplatina/efeitos adversos , Leucovorina/uso terapêutico , Leucovorina/efeitos adversos , Estudos Retrospectivos , Desoxicitidina , Neoplasias Pancreáticas/tratamento farmacológico , Neoplasias Pancreáticas/cirurgia , Fluoruracila/uso terapêutico , Paclitaxel/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Ontário/epidemiologia , Neoplasias Pancreáticas
15.
Clin Oncol (R Coll Radiol) ; 35(3): 188-198, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-36610878

RESUMO

AIMS: To evaluate the safety and effectiveness of oxaliplatin-based combination chemotherapy for patients with metastatic colorectal cancer (mCRC) to extrahepatic sites. MATERIALS AND METHODS: We conducted a population-based retrospective study examining the safety and effectiveness of perioperative oxaliplatin for resectable or potentially resectable colorectal metastases in Ontario, Canada. Outcomes were also compared with patients with liver-only metastases. Patients received oxaliplatin for mCRC between 1 January 2013 and 30 June 2020. RESULTS: In total, 192 patients had extrahepatic metastases. Seventy per cent had R0 metastasectomy. The 3-year disease-free survival and overall survival were 62% and 79%, respectively; <4% of patients died within 60 days of metastasectomy and 74-90% of patients received treatment according to recommendations from a multidisciplinary setting. Compared with liver-only controls (n = 1306), patients had mCRC to the lung only (n = 115), lung and liver (n = 55) and liver with non-pulmonary site (n = 22). Extrahepatic metastases were more likely to be found for patients whose primary colorectal resection had positive margins (14% versus 7%, P = 0.005) and primary tumours located in the rectum [odds ratio 4.01 (2.31-6.97)]. After adjustment, there was no difference in overall survival between liver-only controls and patients with lung-only [hazard ratio 0.82 (0.59-1.15)] or liver and lung metastases [hazard ratio 1.26 (0.85-1.87)] (P = 0.24). In total, 79/115 (69%) of patients with lung-only metastases had a metastasectomy compared with 645/1306 (49%) and 15/55 (27%) of patients with liver-only and liver and lung metastases, respectively. Hospital visits were similar between patients with liver-only and extrahepatic metastases. CONCLUSION: Oxaliplatin-based chemotherapy for patients with resectable or potentially resectable mCRC with extrahepatic metastases was safe and resulted in similar outcomes in appropriately selected patients when compared with patients with liver-only metastases.


Assuntos
Neoplasias do Colo , Neoplasias Colorretais , Neoplasias Hepáticas , Neoplasias Pulmonares , Neoplasias Retais , Humanos , Oxaliplatina/uso terapêutico , Neoplasias Colorretais/tratamento farmacológico , Neoplasias Colorretais/cirurgia , Estudos Retrospectivos , Estudos de Coortes , Neoplasias do Colo/tratamento farmacológico , Neoplasias Retais/tratamento farmacológico , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/cirurgia , Neoplasias Hepáticas/secundário , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/cirurgia , Ontário , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
16.
Environ Res ; 216(Pt 4): 114773, 2023 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-36379238

RESUMO

Herein electrochemical oxidation (EO) is proposed as a novel path to treat the process water obtained from hydrothermal carbonization of olive tree pruning. The aim of this work is to analyze the organic matter removal achieved by the treatment along with the identification of the chemical species formed after the electro-oxidation process at different experimental conditions. Three different tests were performed in a boron doped diamond cell, using Na2SO4 and NaCl as supporting electrolytes to compare the results obtained with the raw process water. The organic matter removal was evaluated by means of total organic carbon and chemical oxygen demand, while Gas Chromatography Mass Spectrometry was used to determine the chemical species present before and after the treatment. The addition of a promoter considerably increased the organic matter removal. In fact, the experiments performed using supporting electrolytes showed the best results in terms of organic matter removal compared to the control experiment (30-40% vs. 17%); This reduction agrees with the volatile fatty acids' measurements. Almost all the chemical species identified in the different feedstocks were partially or totally removed after the EO treatment depending on the experimental conditions. The specific energy consumption and the cost calculated for the treatment is highly dependent on the time of electro-oxidation and the supporting electrolyte used, obtaining values from 1 to 45 €/kg CODremoved. All in all, this work suggests an interesting path towards a further utilization of process water from hydrothermal carbonization processes.


Assuntos
Poluentes Químicos da Água , Água , Poluentes Químicos da Água/análise , Eletrodos , Diamante , Oxirredução , Eletrólitos/química
17.
Rev. esp. anestesiol. reanim ; 69(10): 693-696, dic. 2022. ilus
Artigo em Espanhol | IBECS | ID: ibc-211949

RESUMO

Presentamos el caso de una paciente de nueve años, con antecedentes de epilepsia y múltiples ingresos por bronconeumonía aspirativa, entre otros, que ingresa en nuestro centro por shock séptico secundario a una neumonía en el lóbulo inferior izquierdo y derrame pleural paraneumónico, con mala evolución. Durante su ingreso, se interviene bajo anestesia combinada para desbridamiento quirúrgico por videotoracoscopia y colocación de drenaje en hidroneuomotórax izquierdo complicado. Para la intervención, se realiza un bloqueo del plano del músculo erector de la espina ecoguiado, junto con una anestesia general. Este bloqueo, permitió, por un lado, disminuir la dosis de opioides postoperatorios, mejorando la ventilación de la paciente y, por otro lado, evitó el uso de diversos fármacos que podían disminuir el umbral epileptógeno y aumentar el riesgo de sufrir una convulsión. Este caso demuestra la importancia de la anestesia locorregional en el paciente pediátrico, un arma anestésica en auge.(AU)


We present the case of a 9 year old patient with a clinical history of epilepsy and various hospitalizations due to aspirative broncopneumonia among others, who was admitted to our hospital because of septic shock secondary to pneumonia of the lower left lobule associated with a parapneumonic pleural effusion and a complicated clinical course. During her stay, the patient undergoes surgical debridement using video assisted thoracoscopic surgery (VATS) under general anaesthesia and the hydropneumothorax is drained. For the procedure an ecoguided erector spinae plane block is performed and combined with general anaesthesia. On one hand this block permitted reduction of perioperative opioid administration and improved the patient's respiration, on the other hand it permitted avoiding the use of drugs, which can lower seizure threshold and increase the risk of convulsions. This case illustrates the importance of locoregional anaesthesia, a technique on the rise in the field of paediatric anaesthesia.(AU)


Assuntos
Humanos , Feminino , Criança , Músculos do Dorso , Toracoscopia , Anestesia por Condução , Pacientes Internados , Exame Físico , Epilepsia , Broncopneumonia , Anestesiologia , Pediatria
18.
Rev Esp Anestesiol Reanim (Engl Ed) ; 69(10): 693-696, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36347756

RESUMO

We present the case of a 9 year old patient with a clinical history of epilepsy and various hospitalizations due to aspirative broncopneumonia among others, who was admitted to our hospital because of septic shock secondary to pneumonia of the lower left lobule associated with a parapneumonic pleural effusion and a complicated clinical course. During her stay, the patient undergoes surgical debridement using video assisted thoracoscopic surgery (VATS) under general anaesthesia and the hydropneumothorax is drained. For the procedure an ecoguided erector spinae plane block is performed and combined with general anaesthesia. On one hand this block permitted reduction of perioperative opioid administration and improved the patient's respiration, on the other hand it permitted avoiding the use of drugs, which can lower seizure threshold and increase the risk of convulsions. This case illustrates the importance of locoregional anaesthesia, a technique on the rise in the field of paediatric anaesthesia.


Assuntos
Bloqueio Nervoso , Humanos , Criança , Feminino , Bloqueio Nervoso/métodos , Dor Pós-Operatória/etiologia , Músculos Paraespinais , Cirurgia Torácica Vídeoassistida/efeitos adversos , Analgésicos Opioides
19.
Phys Rev E ; 106(4-1): 044125, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36397542

RESUMO

The basic Lipkin-Meshkov-Glick model displays a second-order ground-state quantum phase transition and an excited-state quantum phase transition (ESQPT). The inclusion of an anharmonic term in the Hamiltonian implies a second ESQPT of a different nature. We characterize this ESQPT using the mean field limit of the model. The alternative ESQPT, associated with the changes in the boundary of the finite Hilbert space of the system, can be properly described using the order parameter of the ground-state quantum phase transition, the energy gap between adjacent states, the participation ratio, and the quantum fidelity susceptibility.

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