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1.
bioRxiv ; 2024 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-38712193

RESUMO

A remarkable demonstration of the flexibility of mammalian motor systems is primates' ability to learn to control brain-computer interfaces (BCIs). This constitutes a completely novel motor behavior, yet primates are capable of learning to control BCIs under a wide range of conditions. BCIs with carefully calibrated decoders, for example, can be learned with only minutes to hours of practice. With a few weeks of practice, even BCIs with randomly constructed decoders can be learned. What are the biological substrates of this learning process? Here, we develop a theory based on a re-aiming strategy, whereby learning operates within a low-dimensional subspace of task-relevant inputs driving the local population of recorded neurons. Through comprehensive numerical and formal analysis, we demonstrate that this theory can provide a unifying explanation for disparate phenomena previously reported in three different BCI learning tasks, and we derive a novel experimental prediction that we verify with previously published data. By explicitly modeling the underlying neural circuitry, the theory reveals an interpretation of these phenomena in terms of biological constraints on neural activity.

2.
Eur J Med Chem ; 272: 116476, 2024 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-38759456

RESUMO

The therapeutic use of the traditional drugs against epilepsy has been hindered by their toxicity and low selectivity. These limitations have stimulated the design and development of new generations of antiepileptic drugs. This review explores the molecular targets and synthesis of the antiepileptic drugs that have entered the market in the 21st century, with a focus on manufacturer synthesis.


Assuntos
Anticonvulsivantes , Epilepsia , Anticonvulsivantes/síntese química , Anticonvulsivantes/farmacologia , Anticonvulsivantes/química , Anticonvulsivantes/uso terapêutico , Humanos , Epilepsia/tratamento farmacológico , Animais , Estrutura Molecular
3.
Pharmaceuticals (Basel) ; 17(4)2024 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-38675447

RESUMO

We present a new category of quinoxaline di-N-oxides (QdNOs) containing amino acid side chains with dual antituberculosis and antileishmanial activity. These compounds were synthesized by combining a regioselective 2,5-piperazinedione opening and a Beirut reaction and were screened for their activity against Mycobacterium tuberculosis and the promastigote and amastigote forms of representative species of the Leishmania genus. Most QdNOs exhibited promising antitubercular activity with IC50 values ranging from 4.28 to 49.95 µM, comparable to clinically established drugs. Structure-activity relationship analysis emphasized the importance of substituents on the aromatic ring and the side chain. Antileishmanial tests showed that some selected compounds exhibited activity comparable to the positive control miltefosine against promastigotes of Leishmania amazonensis and Leishmania donovani. Notably, some compounds were found to be also more potent and less toxic than miltefosine in intracellular amastigote assays against Leishmania amazonensis. The compound showing the best dual antitubercular and leishmanicidal profile and a good selectivity index, 4h, can be regarded as a hit compound that opens up new opportunities for the development of integrated therapies against co-infections.

4.
Molecules ; 29(6)2024 Mar 07.
Artigo em Inglês | MEDLINE | ID: mdl-38542833

RESUMO

A group of functionalized fluorene derivatives that are structurally similar to the cellular prion protein ligand N,N'-(methylenedi-4,1-phenylene)bis [2-(1-pyrrolidinyl)acetamide] (GN8) have been synthesized. These compounds show remarkable native fluorescence due to the fluorene ring. The substituents introduced at positions 2 and 7 of the fluorene moiety are sufficiently flexible to accommodate the beta-conformational folding that develops in amyloidogenic proteins. Changes in the native fluorescence of these fluorene derivatives provide evidence of transformations in the amyloidogenic aggregation processes of insulin. The increase observed in the fluorescence intensity of the sensors in the presence of native insulin or amyloid aggregates suggest their potential use as fluorescence probes for detecting abnormal conformations; therefore, the compounds can be proposed for use as "turn-on" fluorescence sensors. Protein-sensor dissociation constants are in the 5-10 µM range and an intermolecular charge transfer process between the protein and the sensors can be successfully exploited for the sensitive detection of abnormal insulin conformations. The values obtained for the Stern-Volmer quenching constant for compound 4 as a consequence of the sensor-protein interaction are comparable to those obtained for the reference compound GN8. Fluorene derivatives showed good performance in scavenging reactive oxygen species (ROS), and they show antioxidant capacity according to the FRAP and DPPH assays.


Assuntos
Amiloide , Insulina , Amiloide/química , Proteínas Amiloidogênicas , Fluorometria , Fluorenos/química
5.
Artigo em Inglês | MEDLINE | ID: mdl-38423465

RESUMO

Spinal cord ischaemia leading to paraplegia or paraparesis is one of the most devastating complications of aortic surgery. The risk of ischaemia is particularly high in repairs involving both the thoracic and abdominal segments, because in these cases blood flow to the spinal arteries can be interrupted. Multimodal protocols have now been developed to reduce the incidence of this complication, and include measures such as cerebrospinal fluid (CSF) drainage, avoidance of hypotension and anaemia, systemic hypothermia, neuromonitoring, maintaining distal perfusion during proximal clamping of the aorta, and reimplantation of intercostal or lumbar arteries, whenever feasible. We describe a case in which, due to the special characteristics of the surgery, veno-arterial extracorporeal membrane oxygenation (VA ECMO) was used to maintain distal blood flow in the lumbar, inferior mesenteric, and hypogastric arteries during aortic clamping. This approach reduced the risk of spinal cord and visceral ischaemia, and also eliminated the need for thoracotomy because partial left bypass was not required.

6.
Molecules ; 29(2)2024 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-38257402

RESUMO

The 1,8-Diazaanthracene-2,9,10-triones, their 5,8-dihydro derivatives, and 1,8-diazaanthracene-2,7,9,10-tetraones, structurally related to the diazaquinomycin family of natural products, were synthesized in a regioselective fashion employing Diels-Alder strategies. These libraries were studied for their cytotoxicity in a variety of human cancer cell lines in order to establish structure-activity relationships. From the results obtained, we conclude that some representatives of the 1,8-diazaanthracene-2,9,10-trione framework show potent and selective cytotoxicity against solid tumors. Similar findings were made for the related 1-azaanthracene-2,9,10-trione derivatives, structurally similar to the marcanine natural products, which showed improved activity over their natural counterparts. An enantioselective protocol based on the use of a SAMP-related chiral auxiliary derived was developed for the case of chiral 5-substituted 1,8-diazaanthracene-2,9,10-triones, and showed that their cytotoxicity was not enantiospecific.


Assuntos
Antracenos , Produtos Biológicos , Humanos , Linhagem Celular , Relação Estrutura-Atividade
7.
Pharmaceutics ; 15(9)2023 Sep 19.
Artigo em Inglês | MEDLINE | ID: mdl-37765313

RESUMO

Many active pharmaceutical ingredients show low oral bioavailability due to factors such as poor solubility and physical and chemical instability. The formation of inclusion complexes with cyclodextrins, as well as cyclodextrin-based polymers, nanosponges, and nanofibers, is a valuable tool to improve the oral bioavailability of many drugs. The microencapsulation process modifies key properties of the included drugs including volatility, dissolution rate, bioavailability, and bioactivity. In this context, we present relevant examples of the stabilization of labile drugs through the encapsulation in cyclodextrins. The formation of inclusion complexes with drugs belonging to class IV in the biopharmaceutical classification system as an effective solution to increase their bioavailability is also discussed. The stabilization and improvement in nutraceuticals used as food supplements, which often have low intestinal absorption due to their poor solubility, is also considered. Cyclodextrin-based nanofibers, which are polymer-free and can be generated using environmentally friendly technologies, lead to dramatic bioavailability enhancements. The synthesis of chemically modified cyclodextrins, polymers, and nanosponges based on cyclodextrins is discussed. Analytical techniques that allow the characterization and verification of the formation of true inclusion complexes are also considered, taking into account the differences in the procedures for the formation of inclusion complexes in solution and in the solid state.

8.
Phys Rev Lett ; 131(5): 052501, 2023 Aug 04.
Artigo em Inglês | MEDLINE | ID: mdl-37595245

RESUMO

We used the ^{138}Ba(d,α) reaction to carry out an in-depth study of states in ^{136}Cs, up to around 2.5 MeV. In this Letter, we place emphasis on hitherto unobserved states below the first 1^{+} level, which are important in the context of solar neutrino and fermionic dark matter (FDM) detection in large-scale xenon-based experiments. We identify for the first time candidate metastable states in ^{136}Cs, which would allow a real-time detection of solar neutrino and FDM events in xenon detectors, with high background suppression. Our results are also compared with shell-model calculations performed with three Hamiltonians that were previously used to evaluate the nuclear matrix element (NME) for ^{136}Xe neutrinoless double beta decay. We find that one of these Hamiltonians, which also systematically underestimates the NME compared with the others, dramatically fails to describe the observed low-energy ^{136}Cs spectrum, while the other two show reasonably good agreement.

9.
J Org Chem ; 88(16): 11778-11792, 2023 Aug 18.
Artigo em Inglês | MEDLINE | ID: mdl-37556760

RESUMO

An efficient, secondary amine-catalyzed cascade annulation of 2-O/N-propargylarylaldehydes with 2,6-dialkylphenols was established to access biologically relevant functionalized 2H-chromenes and 1,2-dihydroquinolines tethered with a synthetically useful p-quinone methide scaffold in high yields under microwave irradiation and conventional heating conditions. The microwave-assisted strategy was convenient, clean, rapid, and high yielding in which the reactions were completed in just 15 min, and the yields obtained were up to 95%. This highly atom-economical domino process constructed two new C-C double bonds and a six-membered O/N-heterocyclic ring in a single synthetic operation. Its mechanism process was rationalized as involving sequential iminium ion formation, nucleophilic addition, and intramolecular annulation steps. Furthermore, the synthesized 2H-chromene derivatives were transformed into valuable indeno[2,1-c]chromenes, 5H-indeno[2,1-c]quinolines, and oxireno[2,3-c]chromene via a palladium-catalyzed double C-H bond activation process and epoxidation, respectively.

10.
Bioorg Med Chem ; 91: 117419, 2023 08 15.
Artigo em Inglês | MEDLINE | ID: mdl-37487339

RESUMO

Multi-target drug discovery is one of the most active fields in the search for new drugs against Alzheimer's disease (AD). This is because the complexity of AD pathological network might be adequately tackled by multi-target-directed ligands (MTDLs) aimed at modulating simultaneously multiple targets of such a network. In a continuation of our efforts to develop MTDLs for AD, we have been focusing on the molecular hybridization of the acetylcholinesterase inhibitor tacrine with the aim of expanding its anti-AD profile. Herein, we manipulated the structure of a previously developed tacrine-quinone hybrid (1). We designed and synthesized a novel set of MTDLs (2-6) by replacing the naphthoquinone scaffold of 1 with that of 2,5,8-quinolinetrione. The most interesting hybrid 3 inhibited cholinesterase enzymes at nanomolar concentrations. In addition, 3 exerted antioxidant effects in menadione-induced oxidative stress of SH-SY5Y cells. Importantly, 3 also showed low hepatotoxicity and good anti-amyloid aggregation properties. Remarkably, we uncovered the potential of the quinolinetrione scaffold, as a novel anti-amyloid aggregation and antioxidant motif to be used in further anti-AD MTDL drug discovery endeavors.


Assuntos
Doença de Alzheimer , Neuroblastoma , Humanos , Tacrina/farmacologia , Tacrina/química , Doença de Alzheimer/tratamento farmacológico , Acetilcolinesterase , Ligantes , Inibidores da Colinesterase/farmacologia , Inibidores da Colinesterase/química , Antioxidantes/farmacologia , Peptídeos beta-Amiloides
11.
Antioxidants (Basel) ; 12(7)2023 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-37508002

RESUMO

Quinones can in principle be viewed as a double-edged sword in the treatment of neurodegenerative diseases, since they are often cytoprotective but can also be cytotoxic due to covalent and redox modification of biomolecules. Nevertheless, low doses of moderately electrophilic quinones are generally cytoprotective, mainly due to their ability to activate the Keap1/Nrf2 pathway and thus induce the expression of detoxifying enzymes. Some natural quinones have relevant roles in important physiological processes. One of them is coenzyme Q10, which takes part in the oxidative phosphorylation processes involved in cell energy production, as a proton and electron carrier in the mitochondrial respiratory chain, and shows neuroprotective effects relevant to Alzheimer's and Parkinson's diseases. Additional neuroprotective quinones that can be regarded as coenzyme Q10 analogues are idobenone, mitoquinone and plastoquinone. Other endogenous quinones with neuroprotective activities include tocopherol-derived quinones, most notably vatiquinone, and vitamin K. A final group of non-endogenous quinones with neuroprotective activity is discussed, comprising embelin, APX-3330, cannabinoid-derived quinones, asterriquinones and other indolylquinones, pyrroloquinolinequinone and its analogues, geldanamycin and its analogues, rifampicin quinone, memoquin and a number of hybrid structures combining quinones with amino acids, cholinesterase inhibitors and non-steroidal anti-inflammatory drugs.

12.
Molecules ; 28(14)2023 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-37513247

RESUMO

Inhibition of cyclooxygenase-2 (COX-2) has been extensively studied as an approach to reduce proinflammatory markers in acute brain diseases, but the anti-neuroinflammatory role of cyclooxygenase-1 (COX-1) inhibition has been rather neglected. We report that m-terphenylamine derivatives are selective COX-1 inhibitors, able to block microglia inflammatory response and elicit a neuroprotective effect. These compounds were synthesized via a three-component reaction of chalcones, ß-ketoesters, and primary amines, followed by hydrolysis/decarboxylation of the ester group. Together with their synthetic intermediates and some urea derivatives, they were studied as inhibitors of COX-1 and COX-2. The m-terphenylamine derivatives, which were selective COX-1 inhibitors, were also analyzed for their ability to block microglia inflammatory and oxidative response. Compound 3b presented an interesting anti-inflammatory and neuroprotective profile by reducing nitrite release, ROS overproduction, and cell death in organotypic hippocampal cultures subjected to LPS. We thus show that COX-1 inhibition is a promising approach to provide enhanced neuroprotection against acute inflammatory processes, which are crucial in the development of a plethora of acute neurodegenerative injuries.


Assuntos
Microglia , Fármacos Neuroprotetores , Ciclo-Oxigenase 2/metabolismo , Neuroproteção , Inibidores de Ciclo-Oxigenase/farmacologia , Anti-Inflamatórios/farmacologia , Anti-Inflamatórios/metabolismo , Fármacos Neuroprotetores/farmacologia , Fármacos Neuroprotetores/metabolismo , Lipopolissacarídeos/farmacologia
13.
Sci Rep ; 13(1): 12291, 2023 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-37516795

RESUMO

The nuclear shell model is one of the prime many-body methods to study the structure of atomic nuclei, but it is hampered by an exponential scaling on the basis size as the number of particles increases. We present a shell-model quantum circuit design strategy to find nuclear ground states by exploiting an adaptive variational quantum eigensolver algorithm. Our circuit implementation is in excellent agreement with classical shell-model simulations for a dozen of light and medium-mass nuclei, including neon and calcium isotopes. We quantify the circuit depth, width and number of gates to encode realistic shell-model wavefunctions. Our strategy also addresses explicitly energy measurements and the required number of circuits to perform them. Our simulated circuits approach the benchmark results exponentially with a polynomial scaling in quantum resources for each nucleus. This work paves the way for quantum computing shell-model studies across the nuclear chart and our quantum resource quantification may be used in configuration-interaction calculations of other fermionic systems.

14.
Clean Technol Environ Policy ; : 1-14, 2023 May 04.
Artigo em Inglês | MEDLINE | ID: mdl-37359169

RESUMO

Mine water can be a renewable and economical source of geothermal and hydraulic energy. Nine discharges from closed and flooded coal mines in the Laciana Valley (León, NW Spain) have been studied. Various technologies for the energy use of mine water, as well as the influence of factors such as temperature, the need for water treatment, investment, potential customers and expansion capacity, have been evaluated by means of a decision-making tool. It is concluded that the most advantageous option is an open-loop geothermal system using the waters of a mountain mine, the temperature of which exceeds 14 °C and whose distance to customers is less than 2 km. A technical-economic viability study for a district heating network designed to supply heating and hot water to six public buildings in the nearby town of Villablino is presented. The proposed use of mine water might help areas that have been greatly affected socioeconomically by the closure of the mines and has other advantages compared to conventional energy systems, such as the reduction of CO2 emissions. Graphical Abstract: It showing the advantages of using mine water as an energy source for district heating and a simplified layout. Supplementary Information: The online version contains supplementary material available at 10.1007/s10098-023-02526-y.

15.
Eur J Med Chem ; 255: 115382, 2023 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-37141706

RESUMO

Alzheimer's Disease (AD) remains one of the most challenging health-related issues for our society. It is becoming increasingly prevalent, especially in developed countries, due to the rising life expectancy and, moreover, represents a considerable economic burden worldwide. All efforts at the discovery of new diagnostic and therapeutic tools in the last decades have invariably met with failure, making AD an incurable illness and underscoring the need for new approaches. In recent years, theranostic agents have emerged as an interesting strategy. They are molecules able to simultaneously provide diagnostic information and deliver therapeutic activity, allowing for the assessment of the molecule activity, the organism response and the pharmacokinetics. This makes these compounds promising for streamlining research on AD drugs and for their application in personalized medicine. We review here the field of small-molecule theranostic agents as promising tools for the development of novel diagnostic and therapeutic resources against AD, highlighting the positive and significant impact that theranostics can be expected to have in the near future in clinical practice.


Assuntos
Doença de Alzheimer , Humanos , Doença de Alzheimer/diagnóstico , Doença de Alzheimer/tratamento farmacológico , Medicina de Precisão , Peptídeos beta-Amiloides
16.
Materials (Basel) ; 16(6)2023 Mar 22.
Artigo em Inglês | MEDLINE | ID: mdl-36984399

RESUMO

UV-benzotriazoles have been identified as water micropollutants that cause serious problems for human health and the environment. Their low concentration in water bodies complicates their detection by direct water analysis, slowing the corrective actions to avoid bioaccumulation. In this regard, the use of graphene-based materials with a high affinity for non-polar molecules has been demonstrated to be a potential tool for the optimal separation and concentration of this type of molecules in solid phase extraction (SPE) processes. This work evaluates the potential of novel reduced graphene oxide aerogels (rGO) as extractants of mixtures of three UV-benzotriazoles in water at low concentrations. These rGO aerogels incorporate graphenic domains into a tough structure of polymeric chains by adding graphene oxide during the synthesis of resorcinol-formaldehyde gels. Aerogels with a different content and ordering of graphenic domains were obtained and characterized using Raman, XRD, SEM and nitrogen adsorption isotherms (-196 °C). The rGO aerogels that performed better as solid phase extractants were those containing 60% rGO. Aerogels with lower rGO contents (40%) required a high-temperature (2000 °C) treatment to render competitive results. The SPE methodology using selected rGO aerogels was optimized by varying the elution solvent, elution time and volume. The best performances, i.e., recoveries of 80-100% and enrichment factors of 12.5-50, were accomplished when using 0.8 mL of tetrahydrofuran (THF) as an elution solvent. As a result, a fast (10 min) and simple extraction method of UV-benzotriazoles in water was attained, achieving a detection limit of 1 ng mL-1. Selected aerogels were finally tested for the SPE of spiked samples of river waters, showing a similar performance to that observed with synthetic mixtures.

17.
Eur J Med Chem ; 245(Pt 1): 114923, 2023 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-36423450

RESUMO

Prion diseases are characterized by the self-assembly of pathogenic misfolded scrapie isoforms (PrPSc) of the cellular prion protein (PrPC). In an effort to achieve a theranostic profile, symmetrical bifunctional carbazole derivatives were designed as fluorescent rigid analogues of GN8, a pharmacological chaperone that stabilizes the native PrPC conformation and prevents its pathogenic conversion. A focused library was synthesized via a four-step route, and a representative member was confirmed to have native fluorescence, including a band in the near-infrared region. After a cytotoxicity study, compounds were tested on the RML-infected ScGT1 neuronal cell line, by monitoring the levels of protease-resistant PrPSc. Small dialkylamino groups at the ends of the molecule were found to be optimal in terms of therapeutic index, and the bis-(dimethylaminoacetamido)carbazole derivative 2b was selected for further characterization. It showed activity in two cell lines infected with the mouse-adapted RML strain (ScGT1 and ScN2a). Unlike GN8, 2b did not affect PrPC levels, which represents a potential advantage in terms of toxicity. Amyloid Seeding Assay (ASA) experiments showed the capacity of 2b to delay the aggregation of recombinant mouse PrP. Its ability to interfere with the amplification of the scrapie RML strain by Protein Misfolding Cyclic Amplification (PMCA) was shown to be higher than that of GN8, although 2b did not inhibit the amplification of human vCJD prion. Fluorescent staining of PrPSc aggregates by 2b was confirmed in living cells. 2b emerges as an initial hit compound for further medicinal chemistry optimization towards strain-independent anti-prion compounds.


Assuntos
Carbazóis , Proteínas PrPC , Doenças Priônicas , Agregados Proteicos , Animais , Camundongos , Carbazóis/química , Carbazóis/farmacologia , Carbazóis/uso terapêutico , Linhagem Celular , Imagem Óptica , Doenças Priônicas/diagnóstico , Doenças Priônicas/tratamento farmacológico , Proteínas PrPC/antagonistas & inibidores , Proteínas PrPC/química , Agregados Proteicos/efeitos dos fármacos
18.
Phys Rev Lett ; 131(26): 262501, 2023 Dec 29.
Artigo em Inglês | MEDLINE | ID: mdl-38215380

RESUMO

The excited states of unstable ^{20}O were investigated via γ-ray spectroscopy following the ^{19}O(d,p)^{20}O reaction at 8 AMeV. By exploiting the Doppler shift attenuation method, the lifetimes of the 2_{2}^{+} and 3_{1}^{+} states were firmly established. From the γ-ray branching and E2/M1 mixing ratios for transitions deexciting the 2_{2}^{+} and 3_{1}^{+} states, the B(E2) and B(M1) were determined. Various chiral effective field theory Hamiltonians, describing the nuclear properties beyond ground states, along with a standard USDB interaction, were compared with the experimentally obtained data. Such a comparison for a large set of γ-ray transition probabilities with the valence space in medium similarity renormalization group ab initio calculations was performed for the first time in a nucleus far from stability. It was shown that the ab initio approaches using chiral effective field theory forces are challenged by detailed high-precision spectroscopic properties of nuclei. The reduced transition probabilities were found to be a very constraining test of the performance of the ab initio models.

19.
Biomedicines ; 10(9)2022 Sep 19.
Artigo em Inglês | MEDLINE | ID: mdl-36140427

RESUMO

The innate immunity toll-like receptor 4 (TLR4) system is a receptor of paramount importance as a therapeutic target. Virtual screening following a "computer-aided drug repurposing" approach was applied to the discovery of novel TLR4 modulators with a non-lipopolysaccharide-like structure. We screened almost 29,000 approved drugs and drug-like molecules from commercial, public, and in-house academia chemical libraries and, after biological assays, identified several compounds with TLR4 antagonist activity. Our computational protocol showed to be a robust approach for the identification of hits with drug-like scaffolds as possible inhibitors of the TLR4 innate immune pathways. Our collaborative work broadens the chemical diversity for inspiration of new classes of TLR4 modulators.

20.
Arch. Soc. Esp. Oftalmol ; 97(9): 483-489, sept. 2022. ilus, tab, graf
Artigo em Espanhol | IBECS | ID: ibc-209101

RESUMO

Objetivo Los procedimientos con sutura ajustable permiten abordar la imprevisibilidad de algunos resultados postoperatorios en la cirugía de estrabismo. El propósito del estudio fue comparar la efectividad de la sutura ajustable y no ajustable en el tratamiento del estrabismo horizontal en niños y en adultos. Método Estudio prospectivo en el que se incluyeron pacientes sometidos a cirugía de estrabismo para la corrección de un estrabismo horizontal con sutura colgante fija (grupo de sutura no ajustable) y sutura ajustable. Se registraron la agudeza visual, la ambliopía, la desviación, la afectación de los músculos oblicuos, las cirugías previas, el nistagmo, la necesidad de ajuste y las complicaciones. Las variables se registraron en el postoperatorio inmediato, a la semana y a los 3 y 6meses. Resultados Se incluyeron 186 pacientes: 157 (84,4%) con sutura ajustable y 29 (15,6%) con sutura no ajustable, de los cuales 119 eran niños y 67 eran adultos. En el postoperatorio, 19 niños (16,0%) y 19 adultos (28,4%) requirieron un ajuste (p=0,044). De 157 pacientes con sutura ajustable, se ajustó al 20% (32/157). El éxito tras el ajuste fue superior para la sutura ajustable (91,72% vs 79,31%; p=0,043) y se mantuvo los 6meses (p<0,05). La cirugía previa (p=0,004) y la exotropía (p=0,018) se relacionaron con la necesidad de ajuste. Conclusiones Un 20% de pacientes con estrabismo horizontal se pueden beneficiar de un ajuste postoperatorio para mejorar el resultado quirúrgico. La sutura ajustable mostró ser superior frente a la sutura colgante fija y supone una excelente opción quirúrgica tanto en niños como en adultos (AU)


Objective Adjustable suture procedures allow addressing the unpredictability of some postoperative results in strabismus surgery. The purpose of the study was to compare the effectiveness of adjustable and non-adjustable suture in the treatment of horizontal strabismus in children and adults. Methods Prospective study including patients undergoing strabismus surgery to correct horizontal strabismus with fixed hanging suture (non-adjustable suture group) and adjustable suture. Visual acuity, amblyopia, deviation, oblique muscle involvement, previous surgeries, nystagmus, need for adjustment, and complications were recorded. The variables were recorded in the immediate postoperative period, at one week and at 3 and 6months. Results 186 patients were included: 157 (84.4%) with adjustable suture and 29 (15.6%) with non-adjustable suture, of which 119 were children and 67 were adults. Postoperatively, 19 children (16.0%) and 19 adults (28.4%) required adjustment (P=.044). Of 157 patients with adjustable suture, it was adjusted in 20% (32/157). Success after adjustment was higher for adjustable suture (91.72% vs 79.31%; P=.043) and remained for 6months (P<.05). Previous surgery (P=.004) and exotropia (P=.018) correlated with the need for adjustment. Conclusions 20% of patients with horizontal strabismus can benefit from a postoperative adjustment to improve the surgical result. The adjustable suture was shown to be superior to the fixed hanging suture and is an excellent surgical option, both in children and adults (AU)


Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Oftalmológicos , Técnicas de Sutura , Estrabismo/cirurgia , Estudos Prospectivos
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