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1.
Nat Commun ; 15(1): 4140, 2024 May 16.
Artigo em Inglês | MEDLINE | ID: mdl-38755138

RESUMO

The goal of this study is to examine the association between in utero drought exposure and epigenetic age acceleration (EAA) in a global climate change hot spot. Calculations of EAA in adults using DNA methylation have been found to accurately predict chronic disease and longevity. However, fewer studies have examined EAA in children, and drought exposure in utero has not been investigated. Additionally, studies of EAA in low-income countries with diverse populations are rare. We assess EAA using epigenetic clocks and two DNAm-based pace-of-aging measurements from whole saliva samples in 104 drought-exposed children and 109 same-sex sibling controls in northern Kenya. We find a positive association between in utero drought exposure and EAA in two epigenetic clocks (Hannum's and GrimAge) and a negative association in the DNAm based telomere length (DNAmTL) clock. The combined impact of drought's multiple deleterious stressors may reduce overall life expectancy through accelerated epigenetic aging.


Assuntos
Mudança Climática , Metilação de DNA , Secas , Epigênese Genética , Efeitos Tardios da Exposição Pré-Natal , Humanos , Feminino , Quênia , Masculino , Criança , Efeitos Tardios da Exposição Pré-Natal/genética , Efeitos Tardios da Exposição Pré-Natal/metabolismo , Gravidez , Envelhecimento/genética , Saliva/metabolismo , Pré-Escolar
2.
J Minim Access Surg ; 2024 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-38214326

RESUMO

INTRODUCTION: Thyroid tumours are a common condition and open surgery is a conventional method for treating benign thyroid tumours when surgery is indicated. In this study, we evaluate the outcomes of benign thyroid tumour treatment using transoral endoscopic thyroidectomy via vestibular approach (TOETVA) and compare the results with those of conventional open thyroidectomy (COT). PATIENTS AND METHODS: We conducted a prospective cohort study between 100 patients who underwent TOETVA and 100 who underwent COT surgery for benign diseases from June 2018 to December 2021 in our hospital. Outcomes between the two groups, including post-operative complications, operative time and length of stay, were compared. RESULTS: The surgical time in the TOETVA group was significantly longer than in the COT group. The operative time of lobectomy in the TOETVA and COT groups was 77.5 ± 13.3 and 51.5 ± 4.2 min, respectively, with a P < 0.001. The operative time of total thyroidectomy in the TOETVA and COT groups was 108.1 ± 7.0 and 65.0 ± 4.1 min, respectively, with a P < 0.001. There was no difference in post-operative length of stay between the two groups. In TOETVA group, there were no patients who converted to open surgery. Amongst all 200 patients in the study, there were no cases of post-operative bleeding. The transient hypoparathyroidism rate after surgery in the TOETVA and COT groups was 3% and 2%, respectively, with no statistically significant difference (P = 0.651). Similarly, the transient recurrent laryngeal nerve injury rate showed no difference between the two groups, with rates of 5% and 4% in the TOETVA and COT groups, respectively (P = 0.733). There were no cases of post-operative infection in either group in our study. At 3 months postoperatively, the cosmetic satisfaction were significantly higher in the endoscopic groups than in the conventional group (P < 0.001). CONCLUSIONS: TOETVA is a safe and effective method, with a low complication rate and optimal aesthetic results compared to traditional surgery to treat benign thyroid tumours.

3.
Ann Surg Oncol ; 31(4): 2357-2358, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38198005

RESUMO

BACKGROUND: Recently, modified radical neck dissection (MRND) for papillary thyroid carcinoma (PTC) has been performed by the transoral endoscopic approach.1 However, dissection of level II lymph nodes using only the transoral approach is highly difficult because of the inadequate axis of surgical view. Hence, we decided to combine the transoral and chest approaches to perform MRND. To the best of our knowledge, this is the first video case of MRND using the combined approach. PATIENT AND METHODS: A 35-year-old woman was diagnosed with cT1aN1bM0 right PTC (metastatic to right level III lymph nodes). The patient underwent total thyroidectomy, bilateral central neck dissection (CND), and right MRND via a combined endoscopic approach: the transoral and chest approaches. Total thyroidectomy and bilateral central neck dissection were performed via the transoral approach, similar to prior studies.2-6 The chest approach can help the surgeon to perform level II and the transoral approach was used to dissect the lymph node of levels III and IV. RESULTS: The total time for total thyroidectomy, bilateral CND, and right MRND was 190 min. The time for MRND was 90 min. The number of harvested lymph nodes were 14 in the right lateral compartments, and the number of metastatic lymph nodes were 2 in the lateral compartments. There were no major postoperative complications. The patient was completely satisfied with the cosmetic result. CONCLUSIONS: The combined approach of the transoral and chest approaches was sufficient to perform total thyroidectomy and MRND for levels II, III, and IV.


Assuntos
Carcinoma Papilar , Neoplasias da Glândula Tireoide , Adulto , Feminino , Humanos , Carcinoma Papilar/cirurgia , Carcinoma Papilar/patologia , Endoscopia , Endoscopia Gastrointestinal , Esvaziamento Cervical , Estudos Retrospectivos , Câncer Papilífero da Tireoide/cirurgia , Câncer Papilífero da Tireoide/patologia , Neoplasias da Glândula Tireoide/cirurgia , Neoplasias da Glândula Tireoide/patologia , Tireoidectomia
4.
Front Endocrinol (Lausanne) ; 14: 1177633, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37334309

RESUMO

Background: The transoral endoscopic thyroidectomy vestibular approach (TOETVA) is increasingly being adopted worldwide because of its many advantages. However, there are few reports on the effectiveness and safety of TOETVA in children. In this study, we report the results of the application of TOETVA on 27 pediatric patients in Vietnam. To the best of our knowledge, this is also the largest sample size of the TOETVA technique performed by a single surgeon on pediatric patients worldwide. Patients and methods: From June 2020 to February 2022, we performed TOETVA on 27 pediatric patients (≤ 18 years old). The outcomes of the procedure were retrospectively reviewed. Results: Our study was conducted on 27 pediatric patients, of whom 24 were female (88.9%). The mean age was 16.3 ± 2 (range 10-18). Fifteen patients had benign thyroid nodules with a mean nodule size of 31.6 ± 7.1 (range 20-50mm), and 12 patients had papillary thyroid carcinoma with a mean nodule size of 10.2 ± 5.6 (range 4-19mm). All 27 patients underwent successful TOETVA without any conversion to open surgery. The 15 patients with benign thyroid nodules had lobectomies with a mean operative time of 83.3 ± 10.5 (range 60-105 minutes). Among the 12 patients diagnosed with thyroid cancer, ten had a lobectomy, isthmusectomy, and central neck dissection, with a mean operative time of 89.8 ± 5.7 (range 80-100 minutes). The other two underwent total thyroidectomy with central lymph node dissection with a mean operative time of 132.5 minutes. The mean hospital stay was 4.7 ± 0.9 (range 3-7 days). No patient had permanent complications, such as hypocalcemia, recurrent laryngeal nerve injury, or mental nerve injury. The rates of temporary recurrent laryngeal nerve injury and mental nerve injury were 3.7% and 11.1% respectively. Conclusions: TOETVA may be a feasible and safe surgical method for children with thyroid disease. However, we recommend that only high-volume thyroid surgeons with experience in TOETVA should perform TOETVA on the pediatric population.


Assuntos
Traumatismos do Nervo Mandibular , Traumatismos do Nervo Laríngeo Recorrente , Cirurgiões , Neoplasias da Glândula Tireoide , Nódulo da Glândula Tireoide , Humanos , Criança , Feminino , Adolescente , Masculino , Tireoidectomia/efeitos adversos , Tireoidectomia/métodos , Nódulo da Glândula Tireoide/cirurgia , Nódulo da Glândula Tireoide/etiologia , Estudos Retrospectivos , Traumatismos do Nervo Laríngeo Recorrente/etiologia , Traumatismos do Nervo Mandibular/etiologia , Traumatismos do Nervo Mandibular/cirurgia , Neoplasias da Glândula Tireoide/patologia
5.
PhytoKeys ; 221: 73-84, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37250351

RESUMO

A new species of Hedyotis L. (Rubiaceae), Hedyotiskonhanungensis B.H. Quang, T.A. Le, K.S. Nguyen & Neupane, is described and illustrated from the central highlands of Vietnam based on morphological and phylogenetic evidence. The new species belongs to the morphologically diverse tribe Spermacoceae (ca. 1000 species) of the family Rubiaceae, which is represented by 70-80 species in Vietnam. The phylogenetic analysis, based on four DNA regions (ITS, ETS, petD, rps 16), confirms the new species' placement within the genus Hedyotis - one of the largest genera in the tribe, comprising ca. 180 species across Asia and the Pacific. Hedyotiskonhanungensis is morphologically distinct from all southeastern Asian Hedyotis L. in its set of traits such as leaf type (shape and thickness), growth habit, and floral parts (color of inflorescence axis and the shape of calyx lobes). The new species shows similarities with Hedyotisshenzhenensis, H.shiuyingiae, and H.yangchunensis from China in its herbaceous habit, fleshy ovate leaf blades, and dark purple floral parts, but it is phylogenetically distinct and can be distinguished from them by the following combination of morphological traits: habit with slightly smaller stature (<25 cm), broadly ovate or deltoid stipules with cuspidate apex and entire margin, and ovate or nearly ovate calyx lobes.

6.
Ann Surg Oncol ; 30(8): 4773-4774, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37244874

RESUMO

BACKGROUND: Although transoral thyroidectomy has become popular in thyroid surgery, transoral robotic thyroidectomy (TORT) has only been successfully applied in a very small number of medical centers worldwide.[1,2,3,4,5] In this video, we show a three-port TORT without an axillary incision for papillary thyroid carcinoma. PATIENT AND METHODS: A 35-year-old female with cT1aN0M0 papillary thyroid carcinoma had a strong motivation to proceed with surgery but avoid external neck incisions. Thus, we decided to perform a hemithyroidectomy with isthmusectomy using a transoral robotic approach, employing the da Vinci Xi surgical system. RESULTS: The operation was completed successfully without conversion to open surgery. The working space creation time, docking time, and console time were 30 min, 40 min, and 130 min, respectively. The pathological results were papillary thyroid carcinoma with 6- and 5-mm tumors. The patient was discharged 4 days after surgery without any complications such as bleeding, infection, mental nerve damage, permanent hoarseness, or hypoparathyroidism. The patient was completely satisfied with the cosmetic result. CONCLUSION: Three-port TORT without an axillary incision is a promising approach with optimal cosmetic outcomes. For Vietnam, a developing country, success in the application of TORT using the new da Vinci Xi robotic platform for thyroid cancer is an important milestone in the development of thyroid surgery.


Assuntos
Procedimentos Cirúrgicos Robóticos , Robótica , Neoplasias da Glândula Tireoide , Feminino , Humanos , Adulto , Tireoidectomia/métodos , Câncer Papilífero da Tireoide/cirurgia , Procedimentos Cirúrgicos Robóticos/métodos , Neoplasias da Glândula Tireoide/cirurgia , Neoplasias da Glândula Tireoide/patologia
7.
Int J Med Robot ; 19(4): e2521, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37104708

RESUMO

BACKGROUND: Transoral robotic thyroidectomy (TORT) is one of the newest approaches and draws attention because of its cosmetic excellence. Here, we present our preliminary data from the initial 5 consecutive patients to explore the feasibility of three-port TORT without axillary incision. METHODS: From August 2022 to December 2022, we performed TORT using three ports via the da Vinci Xi system with three robotic arms. RESULTS: All 5 patients had cT1aN0M0 papillary thyroid carcinomas with a mean tumour size of 6 mm. All patients underwent lobectomy with ipsilateral central neck dissection. The mean surgical time was 170 ± 15,8 min; the average length of hospital stay is 4.2 days. The number of retrieved central lymph nodes was 4.2 ± 0.8. All patients were discharged uneventfully without complications and completely satisfied with the cosmetic results. CONCLUSIONS: TORT is feasible and safe when performed on carefully selected patients by experienced surgeons.


Assuntos
Procedimentos Cirúrgicos Robóticos , Robótica , Neoplasias da Glândula Tireoide , Humanos , Tireoidectomia/métodos , Procedimentos Cirúrgicos Robóticos/métodos , Neoplasias da Glândula Tireoide/cirurgia , Neoplasias da Glândula Tireoide/patologia , Vietnã , Esvaziamento Cervical/métodos , Estudos Retrospectivos
8.
J Neural Eng ; 20(2)2023 03 07.
Artigo em Inglês | MEDLINE | ID: mdl-36720162

RESUMO

Objective.Intracranial electroencephalogram (iEEG) plays a critical role in the treatment of neurological diseases, such as epilepsy and Parkinson's disease, as well as the development of neural prostheses and brain computer interfaces. While electrode geometries vary widely across these applications, the impact of electrode size on iEEG features and morphology is not well understood. Some insight has been gained from computer simulations, as well as experiments in which signals are recorded using electrodes of different sizes concurrently in different brain regions. Here, we introduce a novel method to record from electrodes of different sizes in the exact same location by changing the size of iEEG electrodes after implantation in the brain.Approach.We first present a theoretical model and anin vitrovalidation of the method. We then report the results of anin vivoimplementation in three human subjects with refractory epilepsy. We recorded iEEG data from three different electrode sizes and compared the amplitudes, power spectra, inter-channel correlations, and signal-to-noise ratio (SNR) of interictal epileptiform discharges, i.e. epileptic spikes.Main Results.We found that iEEG amplitude and power decreased as electrode size increased, while inter-channel correlation did not change significantly with electrode size. The SNR of epileptic spikes was generally highest in the smallest electrodes, but 39% of spikes had maximal SNR in larger electrodes. This likely depends on the precise location and spatial spread of each spike.Significance.Overall, this new method enables multi-scale measurements of electrical activity in the human brain that can facilitate our understanding of neurophysiology, treatment of neurological disease, and development of novel technologies.


Assuntos
Eletrocorticografia , Epilepsia , Humanos , Eletrocorticografia/métodos , Eletroencefalografia/métodos , Encéfalo , Eletrodos
9.
AMIA Annu Symp Proc ; 2023: 540-549, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38222391

RESUMO

We present a method to enrich controlled medication terminology from free-text drug labels. This is important because, while controlled medication terminology capture well-structured medication information, much of the information pertaining to medications is still found in free-text. First, we compared different Named Entity Recognition (NER) models including rule-based, feature-based, deep learning-based models with Transformers as well as ChatGPT, few-shot and fine-tuned GPT-3 to find the most suitable model that accurately extracts medication entities (ingredients, brand, dose, etc.) from free-text. Then, a rule-based Relation Extraction algorithm transforms NER results into a well-structured medication knowledge graph. Finally, a Medication Searching method takes the knowledge graph and matches it to relevant medications in the terminology server. An empirical evaluation on real-world drug labels shows that BERT-CRF was the most effective NER model with F-measure 95%. After performing terms normalization, the Medication Searching achieved an accuracy of 77% for when matching a label to relevant medication in the terminology server. The NER and Medication Searching models could be deployed as a web service capable of accepting free-text queries and returning structured medication information; thus providing a useful means of better managing medications information found in different health systems.


Assuntos
Algoritmos , Rotulagem de Medicamentos , Humanos , Vocabulário Controlado
10.
Epigenetics ; 17(13): 2421-2433, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-36242778

RESUMO

Pastoralists in East Africa are among the world's most vulnerable communities to climate change, already living near their upper thermal limits and engaging in a climate-sensitive livelihood in a climate change global hot spot. Pregnant women and children are even more at risk. Here, we report the findings of a study characterizing Samburu pastoralist women's experiences of severe drought and outcomes in their children (N = 213, 1.8-9.6 y). First, we examined potential DNA methylation (DNAm) differences between children exposed to severe drought in utero and same-sex unexposed siblings. Next, we performed a high-dimensional mediation analysis to test whether DNAm mediated associations of exposure to severe drought with body weight and adiposity. DNAm was measured using the Infinium MethylationEPIC BeadChip array. After quality control; batch, chip, and genomic inflation corrections; covariate adjustment; and multiple testing correction, 16 CpG sites were differentially methylated between exposed and unexposed children, predominantly in metabolism and immune function pathways. We found a significant indirect effect of drought exposure on child body weight through cg03771070. Our results are the first to identify biological mediators linking severe drought to child growth in a low-income global hot spot for climate change. A better understanding of the mechanisms underlying the association between drought exposure and child growth is important to increasing climate change resilience by identifying targets for intervention.


For pregnant women in populations engaging in climate-sensitive livelihoods, severe drought is characterized by multiple stressors, including intense, sometimes hazardous labour, food and water insecurity, and other stressors. This study found differential methylation between children exposed to severe drought in utero versus their unexposed same-sex siblings in 16 CpG sites in pathways relevant to the immune system and metabolism. Cg03771070 was found to mediate the association between severe drought exposure and child body weight. The necessary next step includes context-nuanced prospective studies to further refine our understanding of biological mechanisms for climate-associated child outcomes. This is necessary for targeted interventions to improve climate change resilience in these communities.


Assuntos
Mudança Climática , Metilação de DNA , Criança , Humanos , Feminino , Gravidez , Quênia , Secas , Epigênese Genética , Obesidade
11.
Front Oncol ; 12: 935294, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35965553

RESUMO

Background: Pediatric PTC is a rare disease. Although, the prognosis is excellent and the mortality rate is low, the role of prophylactic central neck dissection is still the subject of debate. The aim was to evaluate both the role and safety of prophylactic central neck dissection (CND) in managing pediatric papillary thyroid cancer (PTC), especially in respect of disease-free survival (DFS). Patients and Methods: In this retrospective study, we collected 54 pediatric cN0 PTC patients (≤ 18 years of age) who were treated from January 2014 to January 2021 at a high-volume thyroid surgery center. Patients were divided into two groups based on the status of prophylactic CND. We analyzed the factors related to the clinicopathological features and recurrence of PTC in children. Results: Of the 54 cN0 patients, 35 underwent prophylactic CND and 19 patients did not undergo prophylactic CND. The two groups were similar in clinical and pathologic features, such as age, gender, tumor size, multifocal status, and follow-up time. The average DFS was 84.4 ± 2.7 months. Log-rank tests on Kaplan-Meier curves revealed that age, gender, tumor size, multifocality, and extrathyroid extension did not relate to DFS time. Furthermore, DFS time was not affected by the extent of thyroidectomy (p=0.07) or RAI treatment (p=0.21). Prophylactic CND was found to increase DFS time for pediatric patients with cN0 PTC (p = 0.003). There was no statistically significant difference in complications such as transient hypocalcemia (p=0.15) and transient recurrent laryngeal nerve injury (p=0.37) between the prophylactic CND group and the no-prophylactic CND group. Conclusion: Prophylactic CND was found to be associated with increased DFS and not with increased rates of complications after surgery.

12.
Stem Cell Res Ther ; 13(1): 108, 2022 03 14.
Artigo em Inglês | MEDLINE | ID: mdl-35287722

RESUMO

AIM: To evaluate the safety and early outcomes of autologous bone marrow mononuclear cell (BMMNC) infusion for liver cirrhosis due to biliary atresia (BA) after Kasai operation. METHODS: An open-label clinical trial was performed from January 2017 to December 2019. Nineteen children with liver cirrhosis due to BA after Kasai operation were included. Bone marrow was harvested through anterior iliac crest puncture under general anesthesia. Mononuclear cells (MNCs) were isolated by Ficoll gradient centrifugation and then infused into the hepatic artery. The same procedure was repeated 6 months later. Serum bilirubin, albumin, alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transferase, and prothrombin time were monitored at baseline, 3 months, 6 months, and 12 months after the first transplantation. Esophagoscopies and liver biopsies were performed in patients whose parents provided consent. Mixed-effect analysis was used to evaluate the changes in Pediatric End-Stage Liver Disease (PELD) scores. RESULTS: The average MNC and CD34+ cell counts per kg body weight were 50.1 ± 58.5 × 106/kg and 3.5 ± 2.8 × 106 for the first transplantation and 57.1 ± 42.0 × 106/kg and 3.7 ± 2.7 × 106 for the second transplantation. No severe adverse events associated with the cell therapy were observed in the patients. One patient died 5 months after the first infusion at a provincial hospital due to the rupture of esophageal varices, while 18 patients survived. Liver function was maintained or improved after infusion, as assessed by biochemical tests. The severity of the disease reduced markedly, with a significant reduction in PELD scores. CONCLUSION: Autologous BMMNC administration for liver cirrhosis due to BA is safe and may maintain or improve liver function. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT03468699. Name of the registry: Vinmec Research Institute of Stem Cell and Gene Technology. https://clinicaltrials.gov/ct2/show/NCT03468699?cond=biliary+atresia&cntry=VN&draw=2&rank=2 . Registered on March 16, 2018. The trial results will also be published according to the CONSORT statement at conferences and reported in peer-reviewed journals.


Assuntos
Atresia Biliar , Doença Hepática Terminal , Atresia Biliar/cirurgia , Medula Óssea , Criança , Humanos , Cirrose Hepática/terapia , Índice de Gravidade de Doença
14.
J Pediatr Surg ; 57(10): 421-424, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35168812

RESUMO

INTRODUCTION: Lateral cervical lymph node metastases (LNM) for pediatric patients with papillary thyroid cancer (PTC) is a poor prognostic factor. We aimed to identify risk factors for lateral LNM. METHODS: This retrospective study had included 48 pediatric patients with papillary thyroid cancer underwent total thyroidectomy and central cervical lymphadenectomy at K hospital from 2016 to 2020. RESULTS: The number of patients in each T stage was as follows: 24 (50.0%) in stage 1, 9 (18.7%) in Stage 2, 8 (16.7%) in Stage 3, and 7 (14.6%) in Stage 4. Most of the patients had LNM with N1a and N1b rates of 83.3% and 62.5%, respectively. Lung metastases were observed at presentation in three patients (6.3%). Univariate analysis revealed that age (p = 0.021), male (p = 0.011), tumor size > 10 mm (p = 0.002), multifocality (p < 0.001), extrathyroidal extension (p = 0.001) and central LNM (p < 0.001) were factors that increase the risk of metastasis to lateral LNM. CONCLUSION: Approximately 62.5% of pediatric patients with PTC exhibited lateral LNM at the time of diagnosis. Our study confirmed that multifocality, maximum tumor diameter, extrathyroidal extension and central LNM were independent risk factors for lateral LNM in pediatric PTC. LEVEL OF EVIDENCE: Level IV.


Assuntos
Neoplasias da Glândula Tireoide , Criança , Humanos , Linfonodos/patologia , Metástase Linfática/patologia , Masculino , Estudos Retrospectivos , Fatores de Risco , Câncer Papilífero da Tireoide/patologia , Câncer Papilífero da Tireoide/cirurgia , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia
16.
Ear Nose Throat J ; 101(3): 170-174, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32791908

RESUMO

OBJECTIVES: The objective of this study was to report the feasibility and safety of a novel 4-trocar approach for transoral endoscopic thyroidectomy via the vestibular. METHODS: In this study, we first used 4 trocars via vestibular area to perform transoral endoscopic thyroidectomy. We reported the safety and surgical feasibility of transoral endoscopic thyroidectomy using a 4-trocar technique in our institute from February 1, 2020, to May 10, 2020. RESULTS: Transoral endoscopic thyroidectomy via the vestibular approach using 4 trocars was carried out in 5 patients. No complications such as bleeding, mental nerve injury, recurrent laryngeal nerve injury, or hypoparathyroidism were reported. All patients were completely satisfied with the cosmetic results. CONCLUSIONS: Transoral endoscopic thyroidectomy with 4 trocars via vestibular approach is an effective and feasible method. Markedly, this technique can assist surgeons to expose and preserve both parathyroid glands and recurrent laryngeal nerve easily when performing transoral endoscopic thyroidectomy.


Assuntos
Hipoparatireoidismo , Cirurgia Endoscópica por Orifício Natural , Traumatismos do Nervo Laríngeo Recorrente , Humanos , Cirurgia Endoscópica por Orifício Natural/métodos , Glândulas Paratireoides/cirurgia , Traumatismos do Nervo Laríngeo Recorrente/etiologia , Instrumentos Cirúrgicos/efeitos adversos , Tireoidectomia/efeitos adversos , Tireoidectomia/métodos
18.
Chemosphere ; 288(Pt 2): 132511, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34688713

RESUMO

Paraoxon is one of the pesticide that can induce toxicity to nervous system of living organisms. In this work, we focused on synthesizing the catalyst Bismuth Vanadate with the properties that can sense the presence of organophosphorus compounds and characterized them with various characterization methods. The structural studies done by XRD, UV spectroscopy and FTIR spectroscopy. Morphological studies were carried by SEM and TEM. Elemental analysis using XPS spectra. The proposed electrocatalyst was successfully applied as the active electrode material modifying the screen printed carbon electrode for electrochemical sensor applications. The results of the studies indicate that bismuth vanadate modified electrode exhibited four electron transfer process for reduction of nitro group and this lead to the superior electrochemical sensing performance for ethyl Paraoxon with a detection limit of 0.03 µM and good sensitivity 0.345 µA µM-1 cm-2 with excellent reproducibility, repeatability, stability and selectivity over common interferents. Furthermore, the practical application was successfully carried using the proposed modified strips to determine Paraoxon presence in the river water sample with satisfactory results. This proposed catalyst can act as a desirable candidate for the rapid electrochemical sensor.


Assuntos
Paraoxon , Praguicidas , Eletrodos , Reprodutibilidade dos Testes
19.
Ann Surg Oncol ; 29(3): 1973-1974, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34694524

RESUMO

BACKGROUND: The transoral endoscopic vestibular approach (TOETVA) for thyroidectomy is gaining popularity (Russell et al. in Thyroid 28(7):825-829, 2018; Le et al. in Surg Laparosc Endosc Percutan Tech 30(3):209-213, 2020; Liao et al. in Laryngoscope 130(6):1603-1608, 2020). TOETVA has been utilized successfully in performing thyroidectomy, parathyroidectomy, and neck dissection, via both endoscopic and robotic techniques (Razavi et al. in Head Neck 40(10):2246-2253, 2018; Otolaryngol Head Neck Surg 159(4):625-629, 2018; Ngo et al. in J ENT, 2020. https://doi.org/10.1177/0145561320943358 ; Ann Surg Oncol 28(5):2766, 2021). In this video, we show bilateral central neck dissection via transoral approach in papillary thyroid carcinoma. PATIENT AND METHODS: A 37-year-old female with no significant medical history was diagnosed pT3bN0M0 intraoperatively with the tumor having slightly invaded the strap muscle. Thus, we decided to perform total thyroidectomy with bilateral central neck dissection via transoral approach. METHODS: Prelaryngeal dissection: in the prelaryngeal compartment, soft tissue containing these lymph nodes was intimately associated with the pyramidal lobe. Right paratracheal dissection: fibrofatty tissue was dissected off the prevertebral fascia and the trachea with preservation of right parathyroid glands. Pretracheal lymph nodes were removed with paratracheal dissection. Left paratracheal dissection: the lymphatic tissue was then dissected off the prevertebral and esophageal musculature and the trachea after identifying the left parathyroid glands. Finally, bilateral central neck dissection was finished with preservation of the nerve and parathyroid glands. RESULTS: The operation was completed successfully without conversion to open surgery. The operative time for central neck dissection was 20 min. There were nine harvested lymph nodes in the central compartments, while there were two metastatic lymph nodes of papillary thyroid carcinoma with 3 × 3 mm maximal dimension. There were no major postoperative complications. CONCLUSION: Central neck dissection via TOETVA is a safe and feasible method in selected patients.


Assuntos
Esvaziamento Cervical , Neoplasias da Glândula Tireoide , Adulto , Feminino , Humanos , Câncer Papilífero da Tireoide/cirurgia , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia
20.
J Nutr Sci Vitaminol (Tokyo) ; 68(6): 488-495, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36596546

RESUMO

The aim of this study is to evaluate the effect of intensive nutrition support on patients with tongue cancer and floor of mouth cancer after surgery at K Hospital, Tan Trieu campus. Study the clinical intervention with a control group. We conducted the intensive nutrition intervention for our patients by giving counseling materials, sample menu and nutritional supplements, while the control group had only advice about dietary regimens. We evaluated a group before and after the intervention, at the same time compare the two groups before and after the intervention. After 1 mo, the intervention group increased 0.51±1.43 kg in comparison with their weight at the beginning; the weight of the control group lost -0.59±2.33 kg; the difference had statistical significance (p=0.025). After 1 and 2 mo of intervention, the rates of the participants without risk of malnutrition in the intervention group increased significantly in comparison with that in the control group; the difference has statistical significance with p=0.001 and p=0.003. In terms of quality of life, patients' problems related to areas including health status, functioning, symptoms of the intervention group improved more greatly than those of the control group. Especially, anorexia symptoms and financial impact were improved well in the intervention group (p=0.033, p=0.018). Nutrition intervention in patients with tongue cancer and floor of mouth cancer has shown a beneficial effect of nutrition counseling and intervention to improve patients' status in terms of nutrition and their quality of life.


Assuntos
Desnutrição , Neoplasias da Língua , Humanos , Neoplasias da Língua/cirurgia , Qualidade de Vida , Soalho Bucal , Avaliação Nutricional , Estado Nutricional , Desnutrição/etiologia , Desnutrição/prevenção & controle
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