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1.
Rev. Asoc. Esp. Neuropsiquiatr ; 43(144): 275-286, julio-diciembre 2023. ilus
Artigo em Espanhol | IBECS | ID: ibc-229019

RESUMO

Con ocasión del centenario de Carlos Castilla del Pino (15 de octubre de 2022) se analiza la relación que existe entre sus dos facetas públicas: la psiquiátrica y la intelectual. Al revisar cronológicamente sus publicaciones aparecen claramente cuatro etapas que oscilan entre esos dos polos: empiezan siendo puramente psiquiátricas (1946-66), se desplazan lue-go hacia lo ensayístico (1966-71), vuelve a predominar la psiquiatría (1971-87) y finalmente se decanta por el ensayo literario-memorístico (1989-2010). El análisis de la recepción que tuvo Castilla del Pino por la psiquiatría académica (hostil) y por la intelectualidad progresista (entusiasta), junto con algunos testimonios personales, acaba de ilustrar esas dos facetas de su personalidad. (AU)


On the occasion of Carlos Castilla del Pino's centenary (15 October 2022), we analyse the relationship between his two public facets: the psychiatric and the intellectual. A chronological review of his publications clearly shows four stages that os-cillate between those two poles: they begin as purely psychiatric (1946-66), then move towards essays (1966-71), psychiatry again predominates (1971-87) and finally he opts for literary-memoiristic essays (1989-2010). The analysis of Castilla del Pino's reception by academic psychiatry (hostile) and by the progressive intelligentsia (enthusiastic), together with some personal testimonies, just illustrate these two facets of his personality. (AU)


Assuntos
Humanos , Psicopatologia , Saúde Mental , Ciúme , Psiquiatria , História
2.
Genetica ; 151(6): 357-367, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37922114

RESUMO

There has been a continuous interest in understanding the patterns of genetic diversity in natural populations because of the role of intraspecific genetic diversity as the basis of all evolutionary change and thus, its potential effects on population persistence when facing environmental changes. Here, we provided the first description of genetic diversity distribution and population structure of Anacardium occidentale L. (cashew) from the Brazilian Cerrado, one of the most economically important tropical crops in the world. We applied Bayesian clustering approaches (STRUCTURE and POPS) that allow predicting the effects of future climatic changes on the population genetic structure of A. occidentale. We identified distinct genetic groups corresponding to the southwestern, central, and northern regions of the species' range. The characterized genetic clusters will disappear under future climate change scenarios, leading to a homogenization of genetic variability across the landscape. Our findings suggest a high likelihood for the loss of genetic diversity, which in turn will reduce the evolutionary potential of the species to cope with predicted future climatic changes. Results from this study may help develop management strategies to conserve the genetic diversity and structure of natural cashew populations.


Assuntos
Anacardium , Mudança Climática , Brasil , Teorema de Bayes , Ecossistema , Genética Populacional , Variação Genética
3.
Acta bioeth ; 29(2)oct. 2023.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1519845

RESUMO

El uso de estrategias de imagen en las redes sociales médicas está cada vez más extendido, cumpliendo el límite ético establecido por el CEM. Sabiendo esto, el presente estudio buscó comprender el problema de la exposición de los pacientes en las redes sociales médicas. Para ello, se realizó una revisión bibliográfica a partir de las bases Scientific Electronic Library Online (Scielo), PubMED, UpToDate, LILACS, incluyendo artículos en inglés, español y portugués publicados a partir de 2018. Así, se percibió en algunas ciudades la tendencia a crear leyes para regular esta exposición, dado que el uso de imágenes se ha vuelto rutinario en la publicidad médica, como una forma de demostrar resultados. Sin embargo, esta práctica está muy acompañada de faltas éticas como recomienda el CFM.


The use of imagem strategies in medical socieal networks is increasingly widespread, meeting the ethical limit established by the CEM. Knowing this, the present study sought to understand the problem of patient exposure in medical social networks. For this, a literature review was carried out from the Scientific Electronic Library Online (Scielo), Pubmed, UpToDate, LILACS databases, articles in English, Spanish and Portuguese published from 2018 onwards were included. Thus, a tendency was noticed in some cities to create laws to regulate this exposure, given that the use of images has become routine in medical advertising, as a way to demonstrate results. However, this practice is greatly accompanied by ethical failures as recommended by the CFM.


A utilização das estratégias de imagem nas redes sociais médicas está cada vez mais disseminada, encontrando-se no limite ético estabelecido pelo CEM. Sabendo disso, o presente estudo buscou entender a problemática da exposição do paciente nas redes sociais médicas. Para isso, foi feita uma revisão da literatura a partir das bases Scientific Eletronic Library Online (Scielo), PubMED, UpToDate, LILACS, foram incluídos artigos em inglês, espanhol e português publicados a partir de 2018. Assim, percebeu-se em algumas cidades a tendência de criar leis para regular essa exposição, haja vista que a utilização de imagens tornou-se rotineira na propaganda médica, como forma demonstrar resultados. Todavia, tal prática vem acompanhada grandemente de falhas éticas segundo o preconizado pelo CFM.

4.
An Acad Bras Cienc ; 94(4): e20200662, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36477986

RESUMO

In this paper, a robust approach to improve the performance of a condition monitoring process in industrial plants by using Pythagorean membership grades is presented. The FCM algorithm is modified by using Pythagorean fuzzy sets, to obtain a new variant of it called Pythagorean Fuzzy C-Means (PyFCM). In addition, a kernel version of PyFCM (KPyFCM) is obtained in order to achieve greater separability among classes, and reduce classification errors. The approach proposed is validated using experimental datasets and the Tennessee Eastman (TE) process benchmark. The results are compared with the results obtained with other algorithms that use standard and non-standard membership grades. The highest performance obtained by the approach proposed indicate its feasibility.

5.
Cureus ; 14(8): e28041, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36120247

RESUMO

While contraception is an important method to avoid pregnancy, it is not always effective. Our case details a 33-year-old-female with an etonogestrel implant who presented to the emergency department (ED) with a two-week history of vomiting and abdominal pain. Pelvic and transvaginal ultrasound confirmed a single, live intrauterine pregnancy. Our case serves as a reminder that ED providers should have a high index of suspicion for pregnancy in clinically relevant scenarios, despite contraceptive methods, until the appropriate confirmatory diagnostic evaluation for pregnancy is completed.

6.
Parasit Vectors ; 15(1): 74, 2022 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-35248140

RESUMO

BACKGROUND: Dengue is endemic in the Philippines. Aedes aegypti is the primary vector. This study aimed to determine the hatching behavior and viability of Ae. aegypti first-generation (F1) eggs when exposed to temperature and photoperiod regimes under laboratory conditions. METHODS: Parental eggs were collected from selected highland and lowland sites in the Philippine big islands (Luzon, Visayas, and Mindanao) during the wet (2017-2018) and dry (2018) seasons. F1 egg cohorts were exposed separately in environmental chambers at 18, 25, and 38 °C with respective photoperiods for 6 weeks. Phenotypes (percent pharate larvae [PPL], hatch rates [HRs], and reproductive outputs [ROs]) were determined. RESULTS: Results of multivariate analyses of variance (MANOVA) between seasons showed significant main effects of temperature, season, and big island on all phenotypes across all sites. Significant interaction effects between seasons on all phenotypes across sites were shown between or among (1) season and big island, (2) season and temperature, (3) big island and temperature, (4) season, big island, and temperature, (5) big island, altitude, and temperature, and (6) season, big island, altitude, and temperature. Factors associated with the big islands might include their ecology, available breeding sites, and day lengths due to latitudinal differences, although they were not measured in the field. MANOVA results within each season on all phenotypes across sites showed (1) significant main effects of big island and temperature, and (2) significant interaction effects between big island and temperature within the wet season and (3) between temperature and photoperiod within the dry season. PPL were highest at 18 °C and were formed even at 38 °C in both seasons. Pharate larvae might play an adaptive role in global warming, expanded distribution to highlands, and preponderance to transmit human diseases. HRs in both seasons were highest at 25 °C and lowest at 38 °C. ROs were highest at 25 °C in the wet season and at 18 °C in the dry season. CONCLUSIONS: Temperature and latitude of Philippine big islands influenced the development-related phenotypes of Ae. aegypti in both seasons. The two seasons influenced the phenotypes and their interaction effects with big island and/or temperature and/or altitude. Recommendations include year-round enhanced 4S control strategies for mosquito vectors and water pipeline installation in rural highlands.


Assuntos
Aedes , Dengue , Animais , Dengue/epidemiologia , Aquecimento Global , Humanos , Fenótipo , Filipinas/epidemiologia , Estações do Ano , Temperatura
9.
ISA Trans ; 127: 259-272, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34511263

RESUMO

Nowadays, how to select the kernel function and their parameters for ensuring high-performance indicators in fault diagnosis applications remains as two open research issues. This paper provides a comprehensive literature survey of kernel-preprocessing methods in condition monitoring tasks, with emphasis on the procedures for selecting their parameters. Accordingly, twenty kernel optimization criteria and sixteen kernel functions are analyzed. A kernel evaluation framework is further provided for helping in the selection and adjustment of kernel functions. The proposal is validated via a KPCA-based monitoring scheme and two well-known benchmark processes.

10.
Lancet Reg Health Am ; 5: 100092, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36776458

RESUMO

Background: From late 2016 to early 2021, cases of Haff disease, a rare cause of rhabdomyolysis, possibly due to poisoning by palytoxin-like compounds in seafood, were detected in Salvador, Brazil. Surveillance was established to detect additional cases aiming at describing the clinical characteristics of the cases, identifying associated factors, estimating disease attack rate, and investigating the presence of biotoxins and trace metals in selected fish specimens obtained from cases. Method: Between December/2016-January/2021, surveillance investigated Haff disease suspected cases, and obtained clinical and fish samples to test. Findings: Of 65 cases investigated during the 2016-2017 outbreak, 43 (66%) had high creatine phosphokinase (CPK) levels. Among those with laboratory-confirmed rhabdomyolysis, 38 (88%) were hospitalized, 11 (26%) required intensive care, and three (7%) dialysis. Ingestion of marine fish 24h before disease onset was reported by 74% of the cases with elevated CPK and by 41% of those without CPK measurement (P=0·02). Attack rate for individuals who ate fish related to the outbreak was 55%. Following this outbreak, surveillance identified 12 suspected cases between 2017-2019, and a second outbreak in 2020-2021, with 16 laboratory-confirmed rhabdomyolysis patients (five required intensive care; one died). No traces of ciguatoxins and metals were detected in fish specimens obtained in 2016, found to be Seriola rivoliana. Some fish samples from 2020 were screened for palytoxin (PlTX)-like compounds and contained detectable levels of molecule fragments characteristics of isobaric PlTX, ovatoxin-a (OVTX-a), OVTX-b and OVTX-d. Interpretation: These findings support the hypothesis that compounds related to PlTX accumulated in marine fish may be the toxic agent causing the disease. Haff disease is a life-threatening condition, requiring clinical suspicion for patients with sudden-onset myalgia following fish ingestion. Suspected cases should be reported to health authorities for investigation.

11.
Edumecentro ; 14: e2459, 2022.
Artigo em Espanhol | LILACS | ID: biblio-1404649

RESUMO

RESUMEN Introducción: el síndrome antifosfolípido es una enfermedad trombofílica, autoinmune, rara, todavía poco conocida por todos los profesionales de la salud, lo cual implica demora en el diagnóstico y en el tratamiento oportuno. Objetivo: exponer los factores de impacto social del síndrome antifosfolípido por su incidencia en la calidad de vida de los pacientes. Métodos: se realizó la revisión de la bibliografía a través del motor de búsqueda Google Académico con los descriptores: síndrome antifosfolípido, morbimortalidad, daño, impacto social, calidad de vida, en las bases de datos SciELO, Medline-Pubmed, Hinari. Resultados: la revisión se centra en cuatro subtemas: Ocurrencia del síndrome antifosfolípido en la morbimortalidad trombótica y obstétrica, La recurrencia de los eventos trombóticos y el daño crónico acumulado, El deterioro de la calidad de vida de los pacientes con síndrome antifosfolípido, e Importancia de la labor educativa en el impacto social del síndrome antifosfolípido. Los cambios en los estilos de vida para la corrección de los factores de riesgo que deben enfrentar estos pacientes, añaden restricciones a su vida diaria y el temor a las recurrencias y a la muerte, provocan alteraciones psicológicas adicionales que motivan atención especializada. Conclusiones: se hace necesario diseñar estrategias de salud a gran escala para la atención integral y multidisciplinaria de los pacientes con síndrome antifosfolípido, que incluyan capacitar a los profesionales de la salud y aplicar acciones educativas que involucren a las familias.


ABSTRACT Introduction: antiphospholipid syndrome is a rare, autoimmune, thrombophilic disease, still little known to all health professionals, which implies delay in diagnosis and timely treatment. Objective: to expose the factors of social impact of the antiphospholipid syndrome due to its incidence in the quality of life of the patients. Methods: the review of the bibliography was carried out through the Google Scholar search engine with the descriptors: antiphospholipid syndrome, morbidity and mortality, damage, social impact, quality of life, in the SciELO, Medline-Pubmed, and Hinari databases. Results: the review focuses on four subtopics: Occurrence of antiphospholipid syndrome in thrombotic and obstetric morbidity and mortality, Recurrence of thrombotic events and accumulated chronic damage, Impairment of quality of life in patients with antiphospholipid syndrome, and Importance of Educational work on the social impact of antiphospholipid syndrome. Changes in lifestyles to correct the risk factors that these patients must face, add restrictions to their daily life and the fear of recurrences and death, cause additional psychological alterations that motivate specialized care. Conclusions: it is necessary to design large-scale health strategies for the comprehensive and multidisciplinary care of patients with antiphospholipid syndrome, which include training health professionals and applying educational actions that involve families.


Assuntos
Qualidade de Vida , Educação Continuada , Educação Médica , Capacitação em Serviço
12.
J Occup Med Toxicol ; 16(1): 49, 2021 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-34772411

RESUMO

BACKGROUND: There are few clinical data on retinal involvement after acute exposure to high concentrations mercury and the available reports are based on a small number of patients suffering chronic exposure. The purpose of this paper is to report findings in workers acutely exposed to very high concentrations of mercury vapor with the aim of providing data on a possible direct retinal involvement. METHODS: Twenty-nine patients and 16 controls were evaluated in a comparative case series. Mercury levels in blood and urine samples, visual acuity (VA), contrast sensitivity (CS), visual field (VF), color discrimination and optical coherence tomography (OCT) were recorded. The pattern reversal visual-evoked potentials (PRVEP), full-field and multifocal electroretinography (ffERG/mfERG), pattern electroretinography (PERG), systemic symptoms, presence of erethism, and electromyography (EMG) were also gathered. A descriptive analysis was performed. The correlations between variables also were studied. In addition, electrophysiological data from those patients with deeper VF defects (group 1) were compared with a normal control group. RESULTS: Twenty-six workers exhibited symptoms of erethism. The EMG showed sensorimotor polyneuropathy and multiple mononeuropathy. The VA was slightly affected in 48.27% (n = 14) of subjects. Loss of CS in at least one of four spatial frequencies and color vision alterations occurred in 96.5% (n = 28) and 44.8% (n = 13), respectively. VF alterations were identified in 72.4% (n = 21) patients. No morphologic changes were seen in the OCT scans. Latencies over 100 milliseconds and reduced amplitudes of P100 were found in the PRVEP (p < 0.05). The reduced amplitude of the b wave at the ffERG, of the P50 at the PERG and of the P1 wave at the mfERG results (p < 0.05) suggested that the outer retina was involved. Significant negative correlations among blood mercury levels, VA, and ffERG were observed. CONCLUSIONS: In this case series, showed that acute exposure to mercury vapor had a hazardous effect on the visual system. Although neurologic and visual pathway involvement was clearly demonstrated, the differences found compared to control support the existence of a direct functional retinal damage and participation in impaired vision in mercury poisoning.

13.
J Environ Manage ; 285: 112134, 2021 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-33588162

RESUMO

Pollution due to waste generated by the oil industry has led to serious damage to ecosystems and the environment. Therefore, preventive and corrective actions must be taken to mitigate the ecological impact of waste resulting from oil-related activities, to explore and implement environment-friendly approaches, and achieve sustainable development. In this study, an alternative treatment for cuttings generated during the drilling of oil wells was investigated by extracting the hydrocarbons present in such cuttings through the use of carbon dioxide under supercritical conditions. The extractions were performed in a Supercritical Fluid Technologies Inc. Model SFT-150 extractor, under varying pressure (2300-6600 psi) and temperature (52-109 °C), while maintaining constant carbon dioxide flow rate and extraction time, to analyse the effect of these two thermodynamic variables on the extraction efficiency. During supercritical extraction, 21.51 g of total hydrocarbons from drill cuttings (oil/kg) were recovered at 6000 psi and 100 °C. The results indicated that pressure had the strongest effect on the extraction yield, with only a small amount of hydrocarbons recovered at the lowest pressure for all fractions. At <3000 psi pressure, increasing the temperature led to a decrease in the amount of recovered hydrocarbons; at >3000 psi pressure, increasing the temperature led to an increase in the extraction yield.


Assuntos
Dióxido de Carbono , Ecossistema , Hidrocarbonetos , Campos de Petróleo e Gás , Temperatura
14.
Environ Sci Pollut Res Int ; 28(9): 10977-10987, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33106907

RESUMO

This work describes the production/characterization of low molar mass chitosan nanoparticles derived from waste shrimp shells (SSC), as well as from a commercial chitosan (CC). The production of low molar mass nanochitosan employed thermal shock, alternating between 100 °C and ambient temperature, followed by grinding the dry material (SSC and CC) in a ball mill, producing around 500 g of nanochitosan per batch. A highlight of the methodology employed is that it enables nanochitosan to be obtained even from a low quality commercial raw material. All particles had diameters smaller than 223 nm, with an average diameter below 25 nm (determined by DLS), while reductions of molar mass were between 8.4-fold and 13.5-fold. The depolymerization process resulted in a reduction in crystallinity of 38.1 to 25.4% and 55.6 to 25.9% in the CC and SSC samples, respectively. The production of nanochitosans was also confirmed by TEM through the observation of crystalline domains with diameters between 5 and 10 nm. This work perfectly reproduces the results on bench scale from previous research. The simple and inexpensive processes enable easy scale-up, representing an important advance in the production chain of biopolymers. Graphical abstract.


Assuntos
Quitosana , Nanopartículas , Animais , Crustáceos , Peso Molecular
15.
Curr Biol ; 30(23): 4710-4721.e4, 2020 12 07.
Artigo em Inglês | MEDLINE | ID: mdl-33035490

RESUMO

Many individuals with seemingly normal hearing abilities struggle to understand speech in noisy backgrounds. To understand why this might be the case, we investigated the neural representation of speech in the auditory midbrain of gerbils with "hidden hearing loss" through noise exposure that increased hearing thresholds only temporarily. In noise-exposed animals, we observed significantly increased neural responses to speech stimuli, with a more pronounced increase at moderate than at high sound intensities. Noise exposure reduced discriminability of neural responses to speech in background noise at high sound intensities, with impairment most severe for tokens with relatively greater spectral energy in the noise-exposure frequency range (2-4 kHz). At moderate sound intensities, discriminability was surprisingly improved, which was unrelated to spectral content. A model combining damage to high-threshold auditory nerve fibers with increased response gain of central auditory neurons reproduced these effects, demonstrating that a specific combination of peripheral damage and central compensation could explain listening difficulties despite normal hearing thresholds.


Assuntos
Perda Auditiva Provocada por Ruído/fisiopatologia , Ruído/efeitos adversos , Mascaramento Perceptivo/fisiologia , Percepção da Fala/fisiologia , Estimulação Acústica , Animais , Cóclea/inervação , Cóclea/fisiopatologia , Nervo Coclear/fisiopatologia , Modelos Animais de Doenças , Gerbillinae , Audição/fisiologia , Humanos , Masculino
16.
Sensors (Basel) ; 20(18)2020 Sep 22.
Artigo em Inglês | MEDLINE | ID: mdl-32971791

RESUMO

This paper presents an accuracy assessment of the main global scale Burned Area (BA) products, derived from daily images of the Moderate-Resolution Imaging Spectroradiometer (MODIS) Fire_CCI 5.1 and MCD64A1 C6, as well as the previous versions of both products (Fire_CCI 4.1 and MCD45A1 C5). The exercise was conducted on the boreal region of Alaska during the period 2000-2017. All the BA polygons registered by the Alaska Fire Service were used as reference data. Both new versions doubled the annual BA estimate compared to the previous versions (66% for Fire_CCI 5.1 versus 35% for v4.1, and 63% for MCD64A1 C6 versus 28% for C5), reducing the omission error (OE) by almost one half (39% versus 67% for Fire_CCI and 48% versus 74% for MCD) and slightly increasing the commission error (CE) (7.5% versus 7% for Fire_CCI and 18% versus 7% for MCD). The Fire_CCI 5.1 product (CE = 7.5%, OE = 39%) presented the best results in terms of positional accuracy with respect to MCD64A1 C6 (CE = 18%, OE = 48%). These results suggest that Fire_CCI 5.1 could be suitable for those users who employ BA standard products in geoinformatics analysis techniques for wildfire management, especially in Boreal regions. The Pareto boundary analysis, performed on an annual basis, showed that there is still a potential theoretical capacity to improve the MODIS sensor-based BA algorithms.

17.
Front Genet ; 11: 259, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32269588

RESUMO

Changes in landscape structure can affect essential population ecological features, such as dispersal and recruitment, and thus genetic processes. Here, we analyze the effects of landscape metrics on adaptive quantitative traits variation, evolutionary potential, and on neutral genetic diversity in populations of the Neotropical savanna tree Tabebuia aurea. Using a multi-scale approach, we sampled five landscapes with two sites of savanna in each. To obtain neutral genetic variation, we genotyped 60 adult individuals from each site using 10 microsatellite loci. We measured seed size and mass. Seeds were grown in nursery in completely randomized experimental design and 17 traits were measured in seedlings to obtain the average, additive genetic variance (V a ) and coefficient of variation (CV a %), which measures evolvability, for each trait. We found that habitat loss increased genetic diversity (He) and allelic richness (AR), and decreased genetic differentiation among populations (F ST ), most likely due to longer dispersal distance of pollen in landscapes with lower density of flowering individuals. Habitat amount positively influenced seed size. Seeds of T. aurea are wind-dispersed and larger seeds may be dispersed to short distance, increasing genetic differentiation and decreasing genetic diversity and allelic richness. Evolvability (CV a %) in root length decreased with habitat amount. Savanna trees have higher root than shoot growth rate in the initial stages, allowing seedlings to obtain water from water tables. Landscapes with lower habitat amount may be more stressful for plant species, due to the lower plant density, edge effects and the negative impacts of agroecosystems. In these landscapes, larger roots may provide higher ability to obtain water, increasing survival and avoiding dying back because of fire. Despite the very recent agriculture expansion in Central Brazil, landscape changes are affecting neutral and adaptive variation in T. aurea. Several populations have low additive genetic variation for some traits and thus, may have limited evolvability, which may jeopardize species long-term persistence. The effect of habitat loss on highly variable neutral loci may only be detected after a certain threshold of population size is attained, that could become dangerously small masking important losses of heterozygosity endangering species conservation.

18.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 42(1): 77-86, Jan.-Feb. 2020. graf
Artigo em Inglês | LILACS | ID: biblio-1055361

RESUMO

The multi-faceted phenomenon known as globalization has a particular impact on the conceptual and practical development of mental health disciplines in general, and psychiatry in particular, across different world regions. To be theoretically and functionally effective, global psychiatry requires an integration of its different components. To such objective, and after a brief review of continental European and Anglo-Saxon contributions, this article examines the history, characteristics, and contributions of Latin/Iberian American and Spanish-speaking psychiatry, in order to substantiate its role in world psychiatry. The Latin American proper (including Portuguese-speaking Brazil), Spain, and U.S.-based Hispanic components are described, revealing an identity that is based on a humanistic tradition, a value-based, culturally-determined clinical approach to patient care, and a pragmatic adaptation of different treatment resources and techniques. These may constitute supportive elements of an instrumental inter-regional bond in the present and future of our discipline.


Assuntos
Humanos , Psiquiatria/tendências , Saúde Mental , Internacionalidade , Espanha , Hispânico ou Latino , Europa (Continente) , Idioma , América Latina
19.
J Minim Invasive Gynecol ; 27(7): 1624-1630, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31931144

RESUMO

The Laparoscopic Approach to Cervical Cancer (LACC) trial changed the surgical management of cervical cancer worldwide. It was a multinational phase III clinical trial that reported lower survival and higher rate of abdominopelvic recurrences in minimally invasive surgery (MIS) than those of open surgery after hysterectomy. It is possible that tumor exposure to the peritoneal cavity in the MIS arm may account for these differences. We propose a novel technique to minimize peritoneal contamination of malignant cells present at the cervical os by placing a vaginal cerclage abdominally to create a seal at the apex of the vagina during MIS radical hysterectomy. The 2 patients in this work remain healthy and disease-free more than 18 months after surgery using this novel technique. We intend this work to serve as a platform both for offering a safe alternative to the open approach supported by the LACC trial and, most importantly, for promoting discussion of the results of the LACC trial and further research on surgical techniques in the treatment of cervical cancer. MIS has repeatedly been shown to have lower rates of infection, fewer complications, and shorter hospital stays while providing oncologic care that is noninferior to open approach.


Assuntos
Histerectomia/efeitos adversos , Histerectomia/métodos , Recidiva Local de Neoplasia/prevenção & controle , Neoplasias do Colo do Útero/cirurgia , Adenocarcinoma/patologia , Adenocarcinoma/cirurgia , Adulto , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/cirurgia , Contenção de Riscos Biológicos/métodos , Feminino , Humanos , Laparoscopia/efeitos adversos , Laparoscopia/métodos , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Minimamente Invasivos/efeitos adversos , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Estadiamento de Neoplasias , Neoplasias do Colo do Útero/patologia
20.
Front Genet ; 11: 606222, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33613620

RESUMO

Plants are one of the most vulnerable groups to fragmentation and habitat loss, that may affect community richness, abundance, functional traits, and genetic diversity. Here, we address the effects of landscape features on adaptive quantitative traits and evolutionary potential, and on neutral genetic diversity in populations of the Neotropical savanna tree Caryocar brasiliense. We sampled adults and juveniles in 10 savanna remnants within five landscapes. To obtain neutral genetic variation, we genotyped all individuals from each site using nine microsatellite loci. For adaptive traits we measured seed size and mass and grown seeds in nursery in completely randomized experimental design. We obtained mean, additive genetic variance (V a ) and coefficient of variation (CV a %), which measures evolvability, for 17 traits in seedlings. We found that landscapes with higher compositional heterogeneity (SHDI) had lower evolutionary potential (CV a %) in leaf length (LL) and lower aboveground dry mass (ADM) genetic differentiation (Q ST ). We also found that landscapes with higher SHDI had higher genetic diversity (He) and allelic richness (AR) in adults, and lower genetic differentiation (F ST ). In juveniles, SHDI was also positively related to AR. These results are most likely due to longer dispersal distance of pollen in landscapes with lower density of flowering individuals. Agricultural landscapes with low quality mosaic may be more stressful for plant species, due to the lower habitat cover (%), higher cover of monocropping (%) and other land covers, and edge effects. However, in landscapes with higher SHDI with high quality mosaic, forest nearby savanna habitat and the other environments may facilitate the movement or provide additional habitat and resources for seed disperses and pollinators, increasing gene flow and genetic diversity. Finally, despite the very recent agriculture expansion in Central Brazil, we found no time lag in response to habitat loss, because both adults and juveniles were affected by landscape changes.

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