Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 266
Filtrar
1.
SAR QSAR Environ Res ; 35(3): 183-198, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38312090

RESUMO

Transfer learning is a machine learning technique that works well with chemical endpoints, with several papers confirming its efficiency. Although effective, because the choice of source/assistant tasks is non-trivial, the application of this technique is severely limited by the domain knowledge of the modeller. Considering this limitation, we developed a purely data-driven approach for source task selection that abstracts the need for domain knowledge. To achieve this, we created a supervised learning setting in which transfer outcome (positive/negative) is the variable to be predicted, and a set of six transferability metrics, calculated based on information from target and source datasets, are the features for prediction. We used the ChEMBL database to generate 100,000 transfers using random pairing, and with these transfers, we trained and evaluated our transferability prediction model (TP-Model). Our TP-Model achieved a 135-fold increase in precision while achieving a sensitivity of 92%, demonstrating a clear superiority against random search. In addition, we observed that transfer learning could provide considerable performance increases when applicable, with an average Matthews Correlation Coefficient (MCC) increase of 0.19 when using a single source and an average MCC increase of 0.44 when using multiple sources.


Assuntos
Aprendizado de Máquina , Relação Quantitativa Estrutura-Atividade , Bases de Dados Factuais
2.
Infect Dis Ther ; 11(6): 2253-2263, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36319943

RESUMO

INTRODUCTION: To promote judicious prescribing of methicillin-resistant Staphylococcus aureus (MRSA)-active therapy for skin and soft tissue infections (SSTI), we previously developed an MRSA risk assessment tool. The objective of this study was to validate this risk assessment tool internationally. METHODS: A multicenter, prospective cohort study of adults with purulent SSTI was performed at seven international sites from July 2016 to March 2018. Patient MRSA risk scores were computed as follows: MRSA infection/colonization history (2 points); previous hospitalization, previous antibiotics, chronic kidney disease, intravenous drug use, human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), diabetes with obesity (1 point each). Predictive performance of MRSA surveillance percentage, MRSA risk score, and estimated MRSA probability (surveillance percentage adjusted by risk score) were quantified using the area under the receiver operating characteristic curves (aROC) and compared. Performance characteristics of different risk score thresholds across varying baseline MRSA prevalence were examined. RESULTS: Two hundred three patients were included. Common SSTI were wounds (28.6%), abscess (25.1%), and cellulitis with abscess (20.7%). Patients with higher risk scores were more likely to have MRSA (P < 0.001). The MRSA risk score aROC (95%CI) [0.748 (0.678-0.819)] was significantly greater than MRSA surveillance percentage [0.646 (0.569-0.722)] (P = 0.016). Estimated MRSA probability aROC [0.781 (0.716-0.845)] was significantly greater than surveillance percentage (P < 0.001) but not the risk score (P = 0.192). The estimated negative predictive value (NPV) of an MRSA score ≥ 1 (i.e., a score of 0) was greater than 90% when MRSA prevalence was 30% or less. CONCLUSION: The MRSA risk score and estimated MRSA probability were significantly more predictive of MRSA compared with surveillance percentage. An MRSA risk score of zero had high predictive value and could help avoid unnecessary empiric MRSA coverage in low-acuity patients. Further study, including impact of such risk assessment tools on prescribing patterns and outcomes are required before implementation.

3.
Braz J Biol ; 82: e262109, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36169525

RESUMO

This integrative literature review study analyzes the findings of the last 5 years of the parasite Angiostrongylus cantonensis. It is known that this nematode is found in the pulmonary arteries of rats, where it remains as a definitive host. From mice, the cycle spreads to animals, such as snails, which in contact with humans can trigger the disease. In humans, the parasite causes several neurological, abdominal manifestations and mainly meningitis. Based on the review of studies, its epidemiology shows worldwide distribution, although there are endemic cases for this parasite, such as asian countries. Laboratory findings generally showed altered CSF with turbidity, increased protein and eosinophilia, which generated meningeal signs in the patient, moreover MRI exams showed multiple alterations. Rare findings of the nematode in the eyeball, lung and signs of peritoneal inflammation were reported, which requires further studies to understand the whole pathophysiology. Finally, conservative treatment based on anthelmintics and anti-inflammatories brought good responses, although there are reports of deaths, which demonstrates the importance in the prevention and therapy of this disease.


Assuntos
Angiostrongylus cantonensis , Anti-Helmínticos , Infecções por Strongylida , Angiostrongylus cantonensis/fisiologia , Animais , Anti-Inflamatórios , Humanos , Camundongos , Ratos , Caramujos/parasitologia , Infecções por Strongylida/epidemiologia
6.
Av. odontoestomatol ; 38(1): 21-29, ene.-mar. 2022. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-203125

RESUMO

Introducción: Una de las dificultades de los tratamientos endodónticos son las variaciones anatómicas de las raíces y sistema de canales radiculares. Existe poca información sobre prevalencia y distribución espacial de estas variaciones en casos reportados con CBCT (del inglés Cone-Beam Computed Tomography). El propósito de la presente revisión fue analizar las variaciones anatómicas en primer y segundo molar permanente mandibular con tratamiento endodóntico evaluadas con CBCT. Materiales y métodos: Se seleccionaron artículos con casos de tratamiento endodóntico en primer o segundo molar permanente mandibular. Se determinaron el número, distribución espacial de variaciones anatómicas radiculares y canales. Además, el número y tipo de alteraciones de forma. Resultados: La mayor prevalencia del número y distribución espacial de raíces en primer molar fue de tres raíces [1M (mesial), 2D (distal)] con un 76,5% y cuatro raíces (2M, 2D) con un 55,6% en segundo molar. La mayor prevalencia del número y distribución de canales radiculares para el primer y segundo molar fue de cuatro canales: 1mesiovestibular, 1mesiolingual, 1distovestibular y 1distolingual, con un 30% y 90,9% de los casos seleccionados respectivamente. La distribución de alteraciones de forma fue de 8,7% para geminación y de 2,1% para taurodontismo. Conclusiones: La variación anatómica de raíces del primer y segundo molar inferior permanente con más frecuencia fue de tres y cuatro respectivamente. La variación anatómica de canales con más frecuencia fue de cuatro: 2M y 2D. El número de alteraciones de forma fueron poco frecuentes, presentando geminaciones y taurodontismo, solo en segundos molares.


Introduction: One of the difficulties of endodontic treatments is the anatomical variations of the roots and the root canal system. There is little information on the prevalence and spatial distribution of these variations in cases reported with CBCT (Cone-Beam Computed Tomography). The purpose of this review was to analyze the anatomical variations in the mandibular first and second permanent molars with endodontic treatment evaluated with CBCT. Materials and methods: Articles with cases of endodontic treatment in the first or second permanent mandibular molar were selected. The number, spatial distribution of anatomical variations of roots and canals were determined. The number and type of shape alterations were also determined. Results: The highest prevalence regarding number and spatial distribution of root in the first molar was three roots (1M (mesial), 2D (distal)) with 76.5% and four roots (2M, 2D) with 55.6% in second molar. The highest prevalence regarding number and distribution of root canals for the first and second molars was four channels: 1 mesiobuccal, 1 mesiolingual, 1 distobuccal and 1 distolingual, with 30% and 90.9% of the cases selected, respectively. The distribution of shape alterations was 8.7% for gemination and 2.1% for taurodontism. Conclusions: The anatomical variation of roots of the first and second permanent lower molars with the most frequency was three and four respectively. The most frequent anatomic variation of channels was four: 2M and 2D. The number of shape alterations were less frequent, presenting geminations and taurodontism, only in second molars.


Assuntos
Humanos , Ciências da Saúde , Endodontia , Dente Molar , Tomografia Computadorizada de Feixe Cônico/instrumentação , Tomografia Computadorizada de Feixe Cônico/métodos
7.
Pulmonology ; 28(2): 113-118, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-32044296

RESUMO

BACKGROUND: Connective tissue diseases (CTD) are frequently associated with interstitial lung disease (ILD), significantly impacting their morbidity and mortality. AIM: Analyze the experience of an autoimmune specialized unit on treating CTD-ILD and characterize the population based on most frequent diseases, imaging patterns, lung function tests results, serology and treatment. Assess mortality and mortality predictors in these patients. METHODS: Retrospective, descriptive and statistical analysis of the CTD-ILD patients followed up at an autoimmune diseases unit during a 6-year period. RESULTS: Over the study period, 75 patients with CTD-ILD were treated with a mean follow-up of 49 ±â€¯31 months. The most frequent CTD were systemic sclerosis and rheumatoid arthritis. ILD was diagnosed prior to CTD in 8% of patients and concomitantly in 35%. Nonspecific interstitial pneumonia was the CT pattern in 60% and 35% had an isolated diminished DLCO on lung function tests. Pulmonary hypertension was present in 12% and it was the single most important mortality predictor (OR 14.41, p = 0.006). Corticosteroids are the mainstay of treatment but biologics were prescribed in 39% of the patients (mostly tocilizumab and rituximab). Two scleroderma patients were recently treated with nintedanib. CONCLUSIONS: ILD is a potential complication of every CTD and can impose a dramatic burden on these patients. The clinical relevance of ILD together with their early expression in the course of the disease underlines the importance of the presence of chest physicians in these units.


Assuntos
Doenças do Tecido Conjuntivo , Pneumonias Intersticiais Idiopáticas , Doenças Pulmonares Intersticiais , Doenças do Tecido Conjuntivo/complicações , Humanos , Pneumonias Intersticiais Idiopáticas/diagnóstico , Pulmão , Doenças Pulmonares Intersticiais/complicações , Doenças Pulmonares Intersticiais/diagnóstico , Estudos Retrospectivos
8.
Braz. j. biol ; 81(3): 566-574, July-Sept. 2021. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1153378

RESUMO

Abstract The native stands of 'candeia' (Eremanthus erythropappus) have been explored through management plans due to the economic potential of essential oil. The rescue of adult trees, as well as the application of silvicultural techniques that favor the restoration of the stand, can contribute to the genetic conservation of this species. This study's objective was to assess the efficiency of propagation techniques for the rescue of 26 matrices of 'candeia' in a natural managed stand and discussion about the rhizogenesis. In August 2017, trees were induced to regrowth by coppice, followed by exposure and scarification of roots. The emergence of shoots and morphology were evaluated according to the origin (i.e., stump or root). After that period, 19 matrices had their sprouts collected for the preparation of apical cuttings. Indole-3-butyric acid (IBA) was applied at the base of the cuttings. Cutting survival at greenhouse exit (GE), rooting at shade house exit (SHE), morphology and root anatomy were evaluated. In 189 days, the scarification of roots promoted 76.92% of budding. The percentage of sprouted matrices, number of shoots per matrice, length, diameter, and shoot length/diameter ratio increased over time. Only 12.2% of the cuttings survived in GE, and of these, 7.9% rooted in SHE. The cutting resulted in the formation of a clonal mini-garden of 'candeia', with seven of the 19 matrices submitted to propagation. The anatomical analyses showed that bud formation occurs from cell redifferentiation in the phloem parenchyma, and presence of crystals on the walls of the vessel elements of the secondary xylem. The shoots induction from scarification of roots could be used as a silvicultural practice for the reestablishment of the native fragments handle.


Resumo Os povoamentos nativos de candeia (Eremanthus erythropappus) vêm sendo explorados por planos de manejo devido ao potencial econômico do óleo essencial. O resgate de árvores adultas, bem como a aplicação de técnicas silviculturais que favoreçam o restabelecimento do povoamento podem contribuir para a conservação genética dessa espécie. O objetivo desse trabalho foi avaliar a eficiência de técnicas de propagação para o resgate de 26 matrizes de candeia em um povoamento natural manejado e discutir sobre a rizogênese. Em agosto de 2017, as árvores foram induzidas à rebrota por meio da decepa, seguida da exposição e escarificação das raízes. A emissão brotações e morfologia foram avaliadas de acordo com a origem (toco ou raiz). Após esse período, 19 matrizes tiveram as brotações recolhidas para o preparo de estacas apicais, que foram tratadas com ácido indolbutírico (AIB). A sobrevivência das estacas na saída da casa de vegetação (SCV), o enraizamento na saída da casa de sombra (SCS), a morfologia e a anatomia da raiz foram avaliados. Aos 189 dias, a escarificação das raízes resultou em 76,92% de emissão de brotos. O percentual de matrizes brotadas, número de brotos por matriz, comprimento, diâmetro e relação comprimento/diâmetro dos brotos aumentaram ao longo do período avaliado. Somente 12,2% das estacas sobreviveram na SCV e 7,9% enraizaram na SCS. A estaquia resultou na formação de um minijardim clonal de candeia com sete das dezenove matrizes submetidas à propagação. As análises anatômicas mostraram a diferenciação das células na região do parênquima floemático e a presença de cristais de inulina nas paredes dos elementos de vaso do xilema secundário. A indução de brotos radiculares pode ser usada como prática silvicultural visando o restabelecimento de fragmentos nativos manejados.


Assuntos
Raízes de Plantas , Asteraceae , Reprodução Assexuada , Árvores , Divisão Celular
9.
Rev. cir. (Impr.) ; 73(4): 420-427, ago. 2021. ilus, tab, graf
Artigo em Espanhol | LILACS | ID: biblio-1388848

RESUMO

Resumen Introducción: La resección anterior baja protegida con una ileostomía en asa (IA) luego de neoadyuvancia es el tratamiento estándar del cáncer del recto bajo localmente avanzado. Objetivos: Investigar la incidencia, características clínicas de la disfunción ileostómica (DI) en estos pacientes y, eventualmente, definir un perfil de riesgo. Materiales y Método: Se analizan 103 pacientes consecutivos. La DI se define como la eliminación por la ileostomía de más de 1,5 litros por día durante 3 o más días consecutivos asociado a distensión y dolor abdominal con intolerancia a la alimentación oral en ausencia de una complicación intraabdominal Clavien-Dindo grado III o mayor. Se comparan el grupo con DI del resto (no DI). Resultados: La DI se presentó en el 14,5% de los casos, se resolvió entre 12 y 70 días (en el 50% superó los 30 días), la tasa de reingreso fue 27% y no hubo reoperaciones en este grupo. No hubo diferencias estadísticamente significativas entre ambos grupos salvo en el tiempo de hospitalizarán y la tasa de reingresos. Discusión: La DI corresponde a un tipo de íleo posoperatorio de gravedad y duración variable que paradojalmente se asocia con la eliminación de altos volúmenes de contenido intestinal por la IA, requiere aporte vigoroso de volumen y electrolitos y en los casos más graves apoyo con nutrición parenteral. El cuadro revierte en plazos variables con manejo conservador. En este estudio no se ha logrado definir un perfil del paciente en riesgo de sufrir esta complicación o factores predictivos de ella.


Background: Diverting loop ileostomy (LI) is commonly performed to protect a distal anastomosis after a low anterior resection. Aim: To investigate the frecuency and clinical features of ileostomic dysfunction (ID) and, eventually, to define a profile of patients at risk of this complicaction. Materials and Method: 103 consecutive patients operated on for rectal cancer were included. ID is defined when the maxime output was more than 1,5 lt/day for three or more consecutive days with biochemical disturbances, associated to abdominal distension and the inability to tolerate oral feeding without postoperative severe complication. Patients with ID were compared with noID group. Results: ID developed in 15 patients, lasting between 12 and 70 days (50% for more then 30 days), the readmission rate was 27% without reoperation in this group. Except for inhospital time and readmission rate, no other difference between both groups were founded. Discussion: ID is a kind of paralitic ileus of variable intensity with paradox high output ileostomy leading to depletion of water and electrolyte imbalance. ID requires reposition of high volumen of fluids and electrolytes and sometimes parenteral nutrition with full recovery in variable periods without invasive treatment. In this study it was not possible to define a patient profile at risk or predictive factores of this complication.


Assuntos
Humanos , Masculino , Feminino , Neoplasias Retais/epidemiologia , Ileostomia/métodos , Obstrução Intestinal/complicações , Neoplasias Retais/complicações , Incidência , Estudos Retrospectivos
10.
Braz J Med Biol Res ; 54(5): e11177, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33825779

RESUMO

Women have always played an important role in the development of toxicology all over the world. Specifically in Brazil, toxicology has had greater female representation than other countries, but women's participation at high hierarchical levels is low. Although more than 62% of the members of the Brazilian Society of Toxicology are women, only 7 out of the 22 presidents have been women throughout its 48 years of existence. This article aims to celebrate women in the field of toxicology in Brazil, based on interviews with five of these scientists who have changed the field of toxicology in Brazil as we know it today, each in their specific sub-areas. These women are: Dr. Ester de Camargo Fonseca Moraes, Dr. Silvia Berlanga de Moraes Barros, Dr. Alice Aparecida da Matta Chasin, Dr. Gisela de Aragão Umbuzeiro, and Dr. Tania Marcourakis. They are not only pioneers but they are also examples of admirable persistence in fighting the adversities presented to them. They broke the glass ceiling and opened doors for future generations of women in science. We hope that this article helps inspire women in their careers in toxicology.


Assuntos
Toxicologia , Brasil , Feminino , Humanos , Toxicologia/tendências
13.
Diabet Med ; 38(2): e14400, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-32918322

RESUMO

AIMS: To evaluate the relationship between self-reported colour-race, genomic ancestry, and metabolic syndrome in an admixed Brazilian population with type 1 diabetes. METHODS: We included 1640 participants with type 1 diabetes. The proportions of European, African and Amerindian genomic ancestries were determined by 46 ancestry informative markers of insertion deletion. Two different sets of analyses were performed to determine whether self-reported colour-race and genomic ancestry were predictors of metabolic syndrome. RESULTS: Metabolic syndrome was identified in 29.8% of participants. In the first model, the factors associated with metabolic syndrome were: female gender (odds ratio 1.95, P < 0.001); diabetes duration (odds ratio 1.04, P < 0.001); family history of type 2 diabetes (odds ratio 1.36, P = 0.019); and acanthosis nigricans (odds ratio 5.93, P < 0.001). Colour-race was not a predictive factor for metabolic syndrome. In the second model, colour-race was replaced by European genomic ancestry. The associated factors were: female gender (odds ratio 1.95, P < 0.001); diabetes duration (odds ratio 1.04, P < 0.001); family history of type 2 diabetes (odds ratio 1.39, P = 0.011); and acanthosis nigricans (odds ratio 6.12, P < 0.001). Physical exercise (≥3 times a week) was a protective factor (odds ratio 0.77, P = 0.041), and European genomic ancestry was not associated with metabolic syndrome but showed an odds ratio of 1.77 (P = 0.05). CONCLUSIONS: Although a higher level of European genomic ancestry was observed among participants with metabolic syndrome in the univariate analysis, this association did not persist after multivariable adjustments. Further prospective studies in other highly admixed populations remain necessary to better evaluate whether the European ancestral component modulates the development of metabolic syndrome in type 1 diabetes.


Assuntos
Diabetes Mellitus Tipo 1/epidemiologia , Exercício Físico/estatística & dados numéricos , Síndrome Metabólica/etnologia , Acantose Nigricans/epidemiologia , Adolescente , Adulto , Indígena Americano ou Nativo do Alasca/genética , Indígena Americano ou Nativo do Alasca/estatística & dados numéricos , População Negra/genética , População Negra/estatística & dados numéricos , Brasil/epidemiologia , Criança , Estudos Transversais , Diabetes Mellitus Tipo 2 , Feminino , Genômica , Humanos , Masculino , Anamnese , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/genética , Pessoa de Meia-Idade , Fatores de Proteção , Fatores de Risco , Fatores Sexuais , População Branca/genética , População Branca/estatística & dados numéricos , Adulto Jovem
14.
Braz J Biol ; 81(3): 566-574, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-32876166

RESUMO

The native stands of 'candeia' (Eremanthus erythropappus) have been explored through management plans due to the economic potential of essential oil. The rescue of adult trees, as well as the application of silvicultural techniques that favor the restoration of the stand, can contribute to the genetic conservation of this species. This study's objective was to assess the efficiency of propagation techniques for the rescue of 26 matrices of 'candeia' in a natural managed stand and discussion about the rhizogenesis. In August 2017, trees were induced to regrowth by coppice, followed by exposure and scarification of roots. The emergence of shoots and morphology were evaluated according to the origin (i.e., stump or root). After that period, 19 matrices had their sprouts collected for the preparation of apical cuttings. Indole-3-butyric acid (IBA) was applied at the base of the cuttings. Cutting survival at greenhouse exit (GE), rooting at shade house exit (SHE), morphology and root anatomy were evaluated. In 189 days, the scarification of roots promoted 76.92% of budding. The percentage of sprouted matrices, number of shoots per matrice, length, diameter, and shoot length/diameter ratio increased over time. Only 12.2% of the cuttings survived in GE, and of these, 7.9% rooted in SHE. The cutting resulted in the formation of a clonal mini-garden of 'candeia', with seven of the 19 matrices submitted to propagation. The anatomical analyses showed that bud formation occurs from cell redifferentiation in the phloem parenchyma, and presence of crystals on the walls of the vessel elements of the secondary xylem. The shoots induction from scarification of roots could be used as a silvicultural practice for the reestablishment of the native fragments handle.


Assuntos
Asteraceae , Raízes de Plantas , Divisão Celular , Reprodução Assexuada , Árvores
15.
Braz. j. med. biol. res ; 54(5): e11177, 2021. graf
Artigo em Inglês | LILACS | ID: biblio-1180739

RESUMO

Women have always played an important role in the development of toxicology all over the world. Specifically in Brazil, toxicology has had greater female representation than other countries, but women's participation at high hierarchical levels is low. Although more than 62% of the members of the Brazilian Society of Toxicology are women, only 7 out of the 22 presidents have been women throughout its 48 years of existence. This article aims to celebrate women in the field of toxicology in Brazil, based on interviews with five of these scientists who have changed the field of toxicology in Brazil as we know it today, each in their specific sub-areas. These women are: Dr. Ester de Camargo Fonseca Moraes, Dr. Silvia Berlanga de Moraes Barros, Dr. Alice Aparecida da Matta Chasin, Dr. Gisela de Aragão Umbuzeiro, and Dr. Tania Marcourakis. They are not only pioneers but they are also examples of admirable persistence in fighting the adversities presented to them. They broke the glass ceiling and opened doors for future generations of women in science. We hope that this article helps inspire women in their careers in toxicology.


Assuntos
Humanos , Feminino , Toxicologia/tendências , Brasil
16.
Rev. cir. (Impr.) ; 72(6): 559-566, dic. 2020. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-1388767

RESUMO

Resumen Introducción: El tratamiento estándar del cáncer del recto localmente avanzado (CRLA) actual es multimodal. La cirugía mínimamente invasiva es factible en el manejo de este tumor, aunque existe controversia sobre sus resultados alejados. Objetivo: Comparar los resultados inmediatos y alejados de una serie laparoscópica (CL) con una serie de cirugía convencional (CA) intervenidos por CRLA. Materiales y Método: Revisión retrospectiva de ambas técnicas de abordaje en un periodo de 14 años. Se analiza la morbilidad, los resultados patológicos, la recidiva local y la sobrevida a largo plazo. Para estimar las curvas de sobrevida se utilizó el método de Kaplan-Meier. Para comparar las curvas de sobrevida se usó el test de log-rank. Resultados: Se compara 163 pacientes intervenidos por CL con 164 operados mediante CA. Ambos grupos resultaron equivalentes en cuanto a las variables demográficas, morbilidad perioperatoria y estadios patológicos finales, salvo un menor tiempo de hospitalización en el grupo CL (p = 0,007). Los tumores bajos recibieron radioterapia preoperatoria en el 90% de los casos. La recidiva local global y la sobrevida a largo plazo no muestran diferencias de acuerdo al tipo de abordaje. Al excluir los pacientes con una lesión en el recto superior se aprecia que los tumores de recto bajo tienen peor pronóstico, independiente de la técnica empleada (p = 0,007). Conclusiones: La CL es equivalente a la CA en el manejo multimodal del CRLA. La inclusión de tumores del recto superior tiende a mejorar artificialmente los resultados de la cirugía en cuanto a recidiva local y sobrevida global.


Introduction: Total mesorectal excison and preoperative radiotherapy are important components of multimodal treatment in patients with a low locally advanced rectal cancer. Short-term results of laparoscopic surgery has proven to be safe but oncological results are unclear. Aim: To compare short-term and oncologic outcomes of laparoscopic and open resection of locally advanced rectal cancer operated on in the same period. Materials and Method: A total of 327 patientes with rectal cancer treated by open and laparoscopic curative surgery were retrospectively reviewed. Long-term follow up was compared using Kaplan-Meier curves and survival data were tested by log rank test. Results: Demographic data, levels of carcinoembryonaric antigen, perioperative morbidity and pathologic stages were similar in both groups, except for less inhospital time in laparoscopic group (p = 0.007). Over 90% of middle and low tumors recived preoperative radiotherapy. Local recurrence and overall survival shows no difference between both groups. Low and middle rectal cancer showed worst prognosis than tumors of the high rectum, no matter of type of surgery (p = 0.007). Conclusions: Laparoscopic surgery is non-inferior to open resection for pathological and oncological outcomes. It's not convenient to include on trials lesions located in the high rectum, usually treated with primary surgery as colon cancer.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Neoplasias Retais/cirurgia , Laparoscopia/métodos , Neoplasias Retais/mortalidade , Neoplasias Retais/radioterapia , Procedimentos Cirúrgicos Operatórios/efeitos adversos , Resultado do Tratamento
17.
Theriogenology ; 156: 171-180, 2020 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-32755716

RESUMO

The objectives of the present study were to: 1) compare the reproductive efficiency of embryo transfer (ET) recipients after synchronization of estrus or a 5-day synchronization of ovulation protocol for fixed time ET (FTET), and 2) determine the effect of reutilization of intravaginal P4 devices (CIDRs), up to four times, in a 5-day FTET protocol. In Experiment 1, 817 dairy heifers were assigned to one of three groups: PGF + estrus detection, 5-d FTET protocol with new (1.38 g P4) or 2nd use CIDR (previously used once for 5 d). Fresh in vitro produced embryos were transferred 7 ± 1 day after estrus (PGF + estrus) or GnRH (5-day FTET). Utilization rate (transferred/treated) was greater (P < 0.001) in heifers submitted to FTET compared to ET after estrus, however pregnancies per ET (P/ET) were not different (P > 0.10). As a result, pregnancy per treated (P/treated) recipient was greater (P < 0.05) in heifers in the 5-day FTET protocol. In Experiment 2, 40 dairy heifers without a corpus luteum (CL) were randomly allocated into one of four groups using new, 2nd use, 3rd use (previously used twice for 5 d/each), or 4th use (previously used thrice for 5 d/each) CIDRs. Circulating P4 was reduced (P < 0.01) with each reutilization. In Experiment 3, ovarian follicular dynamics were evaluated in 238 dairy heifers submitted to a 5-day protocol with either new, 2nd use, 3rd use or 4th use CIDRs at random stages of the estrous cycle. Prostaglandin F2α (PGF) was administered at CIDR removal and again 24 h later. Ovulation was induced by GnRH treatment 72 h after CIDR removal. Preovulatory follicle diameter increased (P < 0.001) progressively with increasing CIDR reutilization. Ovulation rate did not differ between treatments, however, interval from CIDR removal to ovulation decreased (P < 0.001) in heifers receiving 3rd and 4th use CIDRs compared to new or 2nd use. Finally, in Experiments 4 and 5, 1203 heifers submitted to a 5-day FTET protocol were randomly assigned to receive either a new CIDR, a 3rd use CIDR (Experiment 4) or a 4th use CIDR (Experiment 5). Despite the increase in CL volume on D5 in heifers treated with 3rd use (P = 0.03) or 4th use CIDRs (P < 0.01), there were no differences (P > 0.05) in utilization rate, P/ET, or P/treated. Thus, use of a 5-day FTET synchronization protocol improves reproductive efficiency by increasing recipient utilization, and reutilization of CIDRs up to four times in recipient dairy heifers does not compromise reproductive performance.


Assuntos
Sincronização do Estro , Progesterona , Animais , Bovinos , Ensaios Clínicos Veterinários como Assunto , Corpo Lúteo , Dinoprosta/farmacologia , Transferência Embrionária/veterinária , Feminino , Hormônio Liberador de Gonadotropina , Inseminação Artificial/veterinária , Ovulação , Gravidez
18.
Arq. bras. med. vet. zootec. (Online) ; 72(3): 695-702, May-June, 2020. ilus, tab
Artigo em Português | LILACS, VETINDEX | ID: biblio-1128849

RESUMO

Com o objetivo de promover, por meio de acesso único e com o uso de endoscópio flexível, ampla exploração da cavidade peritoneal de equinos em estação, foi concebida uma cânula laparoscópica para dar sustentação ao endoscópio e possibilitar o acesso sob visualização. O procedimento foi realizado a partir da fossa paralombar. Após pequena incisão cutânea, o endoscópio foi inserido na cânula e os músculos e o peritônio foram divulsionados mediante rotação da cânula. Logo depois da perfuração do peritônio, foi realizada a exploração da cavidade e a identificação das estruturas. Em seguida à exploração do lado ipsilateral ao acesso, realizou-se a transposição do conjunto cânula/endoscópio ventralmente à porção caudal do cólon descendente, seguida de exploração do lado contralateral. Concluída a técnica, foi executado, para fins de comparação, o mesmo procedimento por meio da fossa paralombar contralateral. Foi possível a transposição do conjunto cânula/endoscópio para o lado contralateral ao acesso em todos os procedimentos. Também foi possível a identificação da maioria das estruturas abdominais tanto pelo acesso esquerdo quanto pelo direito. A abordagem por acesso único mostrou-se viável para a exploração ampla da cavidade peritoneal, demonstrando ser uma alternativa à técnica laparoscópica convencional.(AU)


A laparoscopic cannula was designed to support a single access approach with a flexible endoscope for the wide exploration of the peritoneal cavity of standing horses. It provides support to the endoscope and allows access to the peritoneal cavity with a visual aid. This procedure was performed through the paralumbar fossa. After a small cutaneous incision, the endoscope was inserted into the cannula, and the muscles and peritoneum were divulsed through the rotation of the cannula. After the peritoneal perforation, cavity exploration and identification of structures were performed. After the exploration of the ipsilateral side of the access, the cannula/endoscope was transposed ventrally to the caudal portion of the descending colon; this was followed by the exploration of the contralateral side. Once this process was completed, the same procedure was performed through the contralateral paralumbar fossa for comparison. It was possible to transpose the cannula/endoscope set to the contralateral access side in all procedures. Further, it was possible to identify most of the abdominal structures in both the left and right access. This single access approach proved to be feasible for the extensive exploration of the peritoneal cavity, thereby indicating it can be an alternative to the conventional laparoscopic technique.(AU)


Assuntos
Animais , Peritônio/diagnóstico por imagem , Endoscópios/veterinária , Cirurgia Vídeoassistida/veterinária , Cânula , Cavalos , Procedimentos Cirúrgicos Minimamente Invasivos/métodos
19.
Arq. bras. med. vet. zootec. (Online) ; 72(1): 25-32, Jan.-Feb. 2020. tab, graf
Artigo em Português | LILACS, VETINDEX | ID: biblio-1088924

RESUMO

A fim de avaliar o efeito de diferentes doses da rbST sobre a dinâmica folicular, a produção e a maturação in vitro de oócitos, 20 vacas Sindi, divididas em três grupos, receberam um dispositivo de progesterona intravaginal, estradiol e PGF2α, além de 2mL de solução salina (grupo controle), 250 (grupo rbST 250) ou 500mg de rbST (grupo rbST 500). Cinco dias depois, realizou-se a ovum pick up, e os complexos cumulus-oócitos (CCOs) recuperados foram selecionados, classificados e maturados in vitro. Os dados de contagem foram comparados pelo procedimento glht (General Linear Hypothesis Test), e os dados em porcentagem foram submetidos ao qui-quadrado, no programa estatístico R, onde as diferenças foram consideradas significativas quando P<0,05. Não houve diferença (P>0,05) entre os grupos quanto à quantidade de folículos e à taxa de maturação. Os grupos rbST 250 e rbST 500 foram significativamente superiores (P<0,05) ao grupo controle em relação ao número de folículos grandes (0,42±0,20 vs. 0). O grupo rbST 500 apresentou maior (P<0,05) porcentagem de oócitos viáveis (91,52%) do que os grupos controle (67,85%) e rbST 250 (53,33%). A rbST aumenta o número de folículos grandes, e 500mg de rbST aumentam a porcentagem de oócitos viáveis em vacas Sindi.(AU)


In order to evaluate the effect of different doses of rbST on the follicular dynamics, production, and in vitro maturation of oocytes, 20 Sindhi cows were divided into three groups, receiving an intravaginal progesterone device, estradiol and PGF2α, and 2mL of solution saline (Control Group), 250 (rbST 250 Group) or 500mg rbST (rbST 500 Group). Five days later, the ovum pick up was performed, and the cumulus-oocyte (CCO) complexes recovered were selected, classified, and matured in vitro. The counting data were compared by the glht (General Linear Hypothesis Test) procedure, and the percentage data were submitted to Qui- square, in the statistical program R, where differences were considered significant when P< 0.05. There was no difference (P> 0.05) between the groups regarding follicle quantity and maturation rate. The rbST 250 and rbST 500 groups were significantly higher (P< 0.05) than the Control group in relation to the number of large follicles (0.42±0.20 versus 0). The rbST 500 group presented higher (P< 0.05) percentage of viable oocytes (91.52%) than the Control (67.85%) and rbST 250 (53.33%) groups. rbST increases the number of large follicles and 500mg rbST increases the percentage of viable oocytes in Sindhi cows.(AU)


Assuntos
Animais , Feminino , Bovinos , Oócitos , Indução da Ovulação/veterinária , Hormônio do Crescimento/administração & dosagem , Técnicas de Maturação in Vitro de Oócitos/veterinária
20.
Rev. cir. (Impr.) ; 71(4): 318-322, ago. 2019. tab, ilus
Artigo em Espanhol | LILACS | ID: biblio-1058278

RESUMO

INTRODUCCIÓN: La enfermedad diverticular de colon sigmoides representa la principal causa de fistulización del colon a órganos vecinos. OBJETIVO: Describir variables clínicas y terapia quirúrgica de esta entidad. MATERIALES Y MÉTODO: Revisión retrospectiva de los casos de fístulas colónicas de origen diverticular (FCD) operados en forma electiva en un centro terciario. RESULTADOS: En un periodo de 30 años se realizó cirugía resectiva por una FCD en 49 pacientes. Los órganos más afectados fueron la vejiga en 33 casos (68%) y la vagina en 6 (12%). La cirugía efectuada fue la sigmoidectomía en 48 casos (5 con una ileostomía de protección) y una operación de Hartmann. La vía de abordaje fue laparoscópica en 4 pacientes y la morbilidad global de la serie fue 20%, sin mortalidad. Con un seguimiento promedio de 87 meses (extremos 16-178) no hubo casos de recidiva de la fístula. CONCLUSIONES: La FCD representa el 26% de los casos intervenidos por una enfermedad diverticular de colon sigmoides, lo que probablemente refleja un diagnóstico tardío. La fístula colovesical (FCV) es la fístula más común por esta causa y en la mitad de los casos tienen una presentación silenciosa. Las fístulas colovaginales ocurren en mujeres histerectomizadas. La cirugía resectiva del colon en pacientes con riesgo normal es la cirugía estándar con buenos resultados a corto y largo plazo. La cirugía laparoscópica es factible y segura especialmente en los casos de FCV.


BACKGROUND: Fistula formation is a well-known complication of diverticular disease (FCD). AIM: Determine the clinical presentation and surgical management of this kind of fistulas. MATERIALS AND METHODS: Retrospective revision of all consecutive scheduled cases operated on in a terciary public centre in a thirty-years period. RESULTS: Forty-nine patients with a segmental resection of sigmoid colon were analized. Colovesical fistulas were the most common type (n = 33), followed by colovaginal (n = 6). Resection with anastomosis was performed in 48 cases and Hartmann type operation in one. Laparoscopic procedure was made in 4 cases without conversion. Complication rate was 20% and two patients were reoperated on, without mortality in this series. Follow up showed no case of recurrence. CONCLUSIONS: FDC represent 26% of cases operated on in our series. Colovesical fistula is the most common type, followed by colovaginal fistula in histerectomized women. Resection and primary anastomosis should be the treatment of choice in average risk patients with acceptable morbidity and good long-term results. Laparoscopic approach is safe, specifically in patients with colovesical fistulas.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Fístula Intestinal/cirurgia , Doenças do Colo/cirurgia , Colo Sigmoide/cirurgia , Estudos Retrospectivos , Seguimentos , Fístula Intestinal/complicações , Resultado do Tratamento , Doenças do Colo/etiologia , Doenças Diverticulares/complicações
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...