RESUMO
Introducción: El objetivo es lograr una plantilla de mapeo de activación cerebral promedio en niños sanos usando la resonancia magnética funcional (RMf), con paradigmas específicos para activar funciones de atención inhibitoria y de memoria de trabajo. Sujetos y métodos: Se realizó una evaluación nutricional y neuropsicológica a 87 niños diestros. Cumplieron los criterios de inclusión 30 (15 niños y 15 niñas) entre 9 y 11 años, a quienes se estudió con RMf con realización de dos pruebas de atención inhibitoria (Go/No Go), con letras e imágenes de alimentos, un test de memoria de trabajo (Test de Atención Continua-Pares Idénticos) y obtención de volúmenes anatómicos. Los datos posteriormente se procesaron con el programa FSL-v5 con un umbral de p < 0,05 (cluster-wise). Las áreas cerebrales activadas se localizaron utilizando una plantilla cerebral estándar del Montreal Neurological Institute y el atlas cortical estructural de Harvard-Oxford. Resultados: En las pruebas de atención inhibitoria hay activación en áreas frontales de predominio derecho, cíngulo, parietales y occipitales, con preponderancia en áreas occipitales en la prueba con alimentos. En la prueba Test de Atención Continua-Pares Idénticos se obtuvo activación de predominio en áreas occipitales, frontales y parietales. Conclusiones: Se obtienen plantillas de mapeo de actividad cerebral en niños sanos con test de atención inhibitoria, de alimentos y de memoria de trabajo. Las áreas de activación corresponden mayoritariamente a las descritas en la bibliografía. Esto nos permite tener patrones basales de activación cerebral para estudiar patologías relacionadas con la atención inhibitoria, la impulsividad y la memoria de trabajo.(AU)
Introduction: The objective is to produce an average brain activation mapping template in healthy children using functional magnetic resonance imaging (fMRI), with specific paradigms for activating inhibitory attention and working memory functions. Subjects and methods: A nutritional and neuropsychological evaluation was performed on 87 right-handed children. The inclusion criteria were met by 30 children (15 boys and 15 girls) between 9 and 11 years old, who were studied with fMRI in two inhibitory attention tests (Go/No Go), with food cues, a working memory test (Continuous Performance Test Identical Pairs) and measurement of anatomical volumes. These data were subsequently processed with the FSL-v5 program, with a threshold of p < 0.05 (cluster-wise). The brain areas activated were located using a standard Montreal Neurological Institute brain template and the Harvard-Oxford structural cortical atlas. Results: The inhibitory attention tests showed activation frontal areas predominantly on the right, and the cingulate, parietal and occipital areas, with preponderance in occipital areas in the food cues test. In the Continuous Performance Test-Identical Pairs test, activation was obtained predominantly in the occipital, frontal and parietal areas. Conclusions: Brain activity mapping templates are obtained in healthy children with tests for inhibitory attention, food cues and working memory. The activation areas are mostly those reported in the literature. This provides baseline brain activation patterns for studying pathologies related to inhibitory attention, impulsivity and working memory.(AU)
Assuntos
Humanos , Masculino , Feminino , Criança , Espectroscopia de Ressonância Magnética , Função Executiva , Cognição , Transtorno do Deficit de Atenção com Hiperatividade , Memória , Neurologia , Doenças do Sistema Nervoso , Saúde da CriançaRESUMO
INTRODUCTION: The objective is to produce an average brain activation mapping template in healthy children using functional magnetic resonance imaging (fMRI), with specific paradigms for activating inhibitory attention and working memory functions. SUBJECTS AND METHODS: A nutritional and neuropsychological evaluation was performed on 87 right-handed children. The inclusion criteria were met by 30 children (15 boys and 15 girls) between 9 and 11 years old, who were studied with fMRI in two inhibitory attention tests (Go/No Go), with food cues, a working memory test (Continuous Performance Test Identical Pairs) and measurement of anatomical volumes. These data were subsequently processed with the FSL-v5 program, with a threshold of p < 0.05 (cluster-wise). The brain areas activated were located using a standard Montreal Neurological Institute brain template and the Harvard-Oxford structural cortical atlas. RESULTS: The inhibitory attention tests showed activation frontal areas predominantly on the right, and the cingulate, parietal and occipital areas, with preponderance in occipital areas in the food cues test. In the Continuous Performance Test-Identical Pairs test, activation was obtained predominantly in the occipital, frontal and parietal areas. CONCLUSIONS: Brain activity mapping templates are obtained in healthy children with tests for inhibitory attention, food cues and working memory. The activation areas are mostly those reported in the literature. This provides baseline brain activation patterns for studying pathologies related to inhibitory attention, impulsivity and working memory.
TITLE: Mapeo neuroanatómico de atención inhibitoria y memoria de trabajo con resonancia magnética funcional en niños sanos.Introducción. El objetivo es lograr una plantilla de mapeo de activación cerebral promedio en niños sanos usando la resonancia magnética funcional (RMf), con paradigmas específicos para activar funciones de atención inhibitoria y de memoria de trabajo. Sujetos y métodos. Se realizó una evaluación nutricional y neuropsicológica a 87 niños diestros. Cumplieron los criterios de inclusión 30 (15 niños y 15 niñas) entre 9 y 11 años, a quienes se estudió con RMf con realización de dos pruebas de atención inhibitoria (Go/No Go), con letras e imágenes de alimentos, un test de memoria de trabajo (Test de Atención Continua-Pares Idénticos) y obtención de volúmenes anatómicos. Los datos posteriormente se procesaron con el programa FSL-v5 con un umbral de p < 0,05 (cluster-wise). Las áreas cerebrales activadas se localizaron utilizando una plantilla cerebral estándar del Montreal Neurological Institute y el atlas cortical estructural de Harvard-Oxford. Resultados. En las pruebas de atención inhibitoria hay activación en áreas frontales de predominio derecho, cíngulo, parietales y occipitales, con preponderancia en áreas occipitales en la prueba con alimentos. En la prueba Test de Atención Continua-Pares Idénticos se obtuvo activación de predominio en áreas occipitales, frontales y parietales. Conclusiones. Se obtienen plantillas de mapeo de actividad cerebral en niños sanos con test de atención inhibitoria, de alimentos y de memoria de trabajo. Las áreas de activación corresponden mayoritariamente a las descritas en la bibliografía. Esto nos permite tener patrones basales de activación cerebral para estudiar patologías relacionadas con la atención inhibitoria, la impulsividad y la memoria de trabajo.
Assuntos
Encéfalo , Memória de Curto Prazo , Masculino , Feminino , Criança , Humanos , Memória de Curto Prazo/fisiologia , Encéfalo/fisiologia , Mapeamento Encefálico , Atenção/fisiologia , Imageamento por Ressonância Magnética/métodos , Testes NeuropsicológicosRESUMO
Objetivo: Establecer las propiedades psicométricas de una medida de Precariedad Laboral (PL) en seis países centroamericanos de habla española (Costa Rica, El Salvador, Guate-mala, Honduras, Nicaragua y Panamá) mediante un conjunto de ítems incluidos en la II Encuesta Centroamericana de Condiciones de Trabajo y Salud (II ECCTS) de 2018 que se correspondían con ítems de la Escala de Precariedad Laboral (EPRES).Método: A partir de una muestra de 3.782 personas asalariadas de 18 años o más, forma-les e informales, en la II ECCTS, se construyó una medida de PL de 10 ítems representan-do tres dimensiones (temporalidad, derechos y ejercicio de derechos), además del salario como variable observada.Resultados: La muestra estuvo compuesta en su mayoría por hombres, con contrato per-manente, con antigüedad laboral de entre 2 a 5 años, un salario entre 301 a 500 dólares, que reportaban tener derechos laborales y ejercerlos. El Análisis Factorial Confirmatorio corroboró la estructura de la escala (RMSEA 0,07; SRMR = 0,05; CFI = 0,96 y TLI = 0,94). Se observó una alta aceptabilidad de medida de PL y los coeficientes de Alpha de Cronbach de las dimensiones fueron >0,59 excepto para temporalidad (0,30). La confiabilidad de la esca-la fue de 0,68, demostró ser sensible y los patrones de PL en mujeres, jóvenes, temporales y países con menores ingresos fueron los esperados.Conclusiones: La medida de PL construida a partir de ítems disponibles de la escala EPRES en el cuestionario de la II ECCTS evidencia propiedades psicométricas aceptables para aproximarnos a la cuantificación epidemiológica de la PL en Centroamérica (AU)
Objective: To examine the psychometric properties of a measure of Employment Precari-ousness (EP) in six Spanish-speaking Central American countries (Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua, and Panama) consisting of items from in the Employ-ment Precariousness Scale (EPRES) included in the 2018 II Central American Survey of Working Conditions and Health (II ECCTS).Methods: The study sample consisted of 3782 salaried persons, age 18 years and older, both formal and informal, who participated in the II ECCTS. We constructed a 10-item EP measure was constructed, grouped into three dimensions (temporality, labor rights, and exercise of these rights), in addition to salary as an observed variable.Results: The sample was composed mostly of men, with a permanent contract, a work-ing age of between 2 to 5 years, a salary between $301 and $500, who have labor rights and who exercise them. The Confirmatory Factor Analysis corroborated the structure of the scale (RMSEA 0.07, SRMR = 0.05, CFI = 0.96 and TLI = 0.94). The EP measure had high ac-ceptability, and the Cronbach alpha coefficients of the dimensions were between 0.59 and 0.72, except for temporality (0.30). The reliability of the full scale was 0.68, was sensitive and the EP profiles in women, youth, temporary workers and lower income countries were as expected. Conclusions: The EP measure constructed from the items available in the EPRES scale used in the II ECCTS questionnaire shows acceptable psychometric properties for epidemi-ological quantification of precarious employment in Central America (AU)
Assuntos
Humanos , Psicometria , 16360 , Saúde Ocupacional , Carga de Trabalho , Salários e Benefícios , América Central , Inquéritos e QuestionáriosRESUMO
Methylphenidate (MPD) is a psychostimulant that is widely prescribed to treat attention deficit-hyperactivity disorder, but it is abused recreationally as well. The nucleus accumbens (NAc) is part of the motivation circuit implicated in drug-seeking behaviors. The NAc neuronal activity was recorded alongside the behavioral activity from young and adult rats to determine if there are significant differences in the response to MPD. The same dose of MPD elicits behavioral sensitization in some animals and behavioral tolerance in others. In adult animals, higher doses of MPD resulted in a greater ratio of tolerance/sensitization. Animals who responded to chronic MPD with behavioral sensitization usually exhibited further increases in their NAc neuronal firing rates as well. Different upregulations of transcription factors (ΔFOSB/CREB), variable proportions of D1/D2 dopamine receptors, and modulation from other brain areas may predispose certain animals to express behavioral and neuronal sensitization versus tolerance to MPD.
Assuntos
Estimulantes do Sistema Nervoso Central , Metilfenidato , Animais , Comportamento Animal , Estimulantes do Sistema Nervoso Central/farmacologia , Relação Dose-Resposta a Droga , Metilfenidato/farmacologia , Neurônios/fisiologia , Ratos , Ratos Sprague-DawleyRESUMO
BACKGROUND: Tellurium is a rare metalloid that exerts high toxicity on cells, especially on bacteria, partly due to reactive oxygen species (ROS) generation. Moreover, it has also been observed that tellurite can target free cell thiols groups (RSH) (i.e. reduced glutathione (GSH)), enhancing the cellular redox imbalance. Additionally, in vitro experiments have suggested that several enzymes can reduce tellurite (IV) to its elemental form (0); where RSH present on their active sites may be responsible for the process. Nevertheless, the mechanisms implemented by bacteria for tellurite reduction and its role in resistance have not been evaluated in vivo. RESULTS: This work shows that tellurite reduction to elemental tellurium is increased under anaerobic conditions in E. coli cells. The in vivo tellurite reduction is related to the intracellular concentration of total RSH, in the presence and absence of oxygen. This metabolization of tellurite directly contributes to the resistance of the bacteria to the oxyanion. CONCLUSIONS: We demonstrated that in vivo tellurite reduction is related to the intracellular thiol concentration, i.e. large availability of cellular RSH groups, results in a more significant reduction of tellurite. Furthermore, we observed that, when the bacterium exhibits less resistance to the oxyanion, a decreased tellurite reduction was seen, affecting the growth fitness. Together, these results let us propose that tellurite reduction and the intracellular RSH content are related to the oxyanion bacterial resistance, this tripartite mechanism in an oxygen-independent anaerobic process.
Assuntos
Escherichia coli , Telúrio , Anaerobiose , OxirreduçãoRESUMO
Methylphenidate (MPD) is the most widely prescribed psychostimulant used in adolescents and adults to treat attention-deficit/hyperactivity disorder (ADHD). The recreational use of MPD is becoming more prevalent because of its ability to improve cognitive enhancement. The ventral tegmental area (VTA) of the brain is highly associated with reward, cognition and addiction to drugs including psychostimulants like MPD. The VTA neuronal activity was recorded alongside the horizontal behavioral activity from freely behaving non-anesthetized rats. Four adolescent and four adult groups were treated with either saline, 0.6, 2.5 or 10.0 mg/kg MPD. In both adolescent and adult animals, the animals responded to MPD in a dose-dependent manner, such that as the dose of MPD increased, more animals and more VTA unit responded to the drug. The same doses of MPD elicited in some animals behavioral and neuronal sensitization and in other animals behavioral and neuronal tolerance. In the 0.6 and 10.0 mg/kg MPD dose groups there were significant differences between the age groups for how many animals expressed behavioral sensitization and behavioral tolerance to chronic MPD exposure. Additionally, the animal's behavioral response to MPD by excitation or attenuation of activity did not always correlate to the VTA neuronal response, and the age group with significantly higher behavioral responses did not always correlate to the age group with significantly higher VTA neuronal responses for a given MPD dose. These findings differ from similar studies recorded from the prefrontal cortex (PFC), which exhibited behavioral responses continuously directly correlated to PFC responses for increasing MPD doses. This demonstrates that unlike other areas of the brain, there is not a direct relationship between VTA firing and behavioral activity, suggesting that there is input or modulation of this area from elsewhere in the brain. Further investigation is needed to clearly understand the relationship between VTA firing rates and behavioral responses to different MPD doses, especially given the significant differences in response between young and adult animals and the increasing use of the drug in adolescent populations.
Assuntos
Estimulantes do Sistema Nervoso Central , Metilfenidato , Animais , Comportamento Animal , Estimulantes do Sistema Nervoso Central/farmacologia , Relação Dose-Resposta a Droga , Metilfenidato/farmacologia , Atividade Motora , Ratos , Ratos Sprague-Dawley , Área Tegmentar VentralRESUMO
INTRODUCTION AND AIMS: Surgery is the main treatment for gastric cancer. D2 radical gastrectomy is associated with a variable postoperative morbidity and mortality rate worldwide. The aim of the present study was to identify the risk factors associated with the postoperative morbidity and mortality of D2 radical gastrectomy, with curative intent, for gastric cancer. MATERIALS AND METHODS: A retrospective case series was conducted, in which the medical records were reviewed of patients with gastric cancer that underwent D2 radical gastrectomy, within the time frame of January 2014 and December 2018. Univariate and multivariate analyses were carried out to identify the risk factors related to postoperative morbidity and mortality within 90 days. RESULTS: The percentages of postoperative morbidity and mortality in 691 patients were 23.3% and 3.3%, respectively. In the multivariate analysis, age ≥70 years (OR = 1.85, 95% CI: 1.25-2.76), ASA III-IV (OR = 2.06, 95% CI: 1.28-3.34), total gastrectomy (OR = 1.96, 95% CI:1.19-3.23), and pancreatosplenectomy (OR = 5.41, 95% CI: 1.42-20.61) were associated with greater postoperative morbidity, and age ≥70 years (OR = 4.92, 95% CI:1.78-13.65), lower BMI (OR = 0.81, 95% CI: 0.71-0.92), and hypoalbuminemia (OR = 0.91, 95% CI: 0.85-0.98) were associated with greater mortality in distal and total D2 radical gastrectomy. CONCLUSIONS: D2 radical gastrectomy for gastric cancer was shown to be a safe treatment, with low postoperative morbidity and mortality rates. Age ≥70 years, ASA III-IV, total gastrectomy, and pancreatosplenectomy were factors associated with a higher complication rate. Age ≥70 years, lower BMI, and hypoalbuminemia were mortality predictors in distal and total radical gastrectomy.
Assuntos
Hipoalbuminemia , Neoplasias Gástricas , Idoso , Gastrectomia/efeitos adversos , Humanos , Hipoalbuminemia/complicações , Hipoalbuminemia/epidemiologia , Morbidade , Estudos Retrospectivos , Fatores de Risco , Neoplasias Gástricas/etiologia , Neoplasias Gástricas/cirurgiaRESUMO
BACKGROUND: Tellurium is a rare metalloid that exerts high toxicity on cells, especially on bacteria, partly due to reactive oxygen species (ROS) generation. Moreover, it has also been observed that tellurite can target free cell thiols groups (RSH) (i.e. reduced glutathione (GSH)), enhancing the cellular redox imbalance. Additionally, in vitro experiments have suggested that several enzymes can reduce tellurite (IV) to its elemental form (0); where RSH present on their active sites may be responsible for the process. Nevertheless, the mechanisms implemented by bacteria for tellurite reduction and its role in resistance have not been evaluated in vivo. RESULTS: This work shows that tellurite reduction to elemental tellurium is increased under anaerobic conditions in E. coli cells. The in vivo tellurite reduction is related to the intracellular concentration of total RSH, in the presence and absence of oxygen. This metabolization of tellurite directly contributes to the resistance of the bacteria to the oxyanion. CONCLUSIONS: We demonstrated that in vivo tellurite reduction is related to the intracellular thiol concentration, i.e. large availability of cellular RSH groups, results in a more significant reduction of tellurite. Furthermore, we observed that, when the bacterium exhibits less resistance to the oxyanion, a decreased tellurite reduction was seen, affecting the growth fitness. Together, these results let us propose that tellurite reduction and the intracellular RSH content are related to the oxyanion bacterial resistance, this tripartite mechanism in an oxygen independent anaerobic process.
Assuntos
Telúrio , Escherichia coli , Oxirredução , AnaerobioseRESUMO
BACKGROUND: Ultrasonography (US) is the method of choice for evaluating thyroid nodules. In 2017, the American College of Radiology (ACR) created a classification system based on US characteristics. For the system to be adopted, it must be reproducible. OBJECTIVES: To determine the intraobserver and interobserver variability of the ACR TI-RADS. METHODS: Cross-sectional study; three radiologists with different levels of experience used the ACR TI-RADS to classify 100 nodules on two occasions one month apart, and we calculated the intraobserver and interobserver variability. RESULTS: Regarding intraobserver variability, the first radiologist had nearly perfect concordance for composition, echogenicity, shape, and margins and substantial concordance for echogenic foci; the second radiologist had nearly perfect concordance for composition, echogenicity, shape, and margins and substantial concordance for echogenic foci, and the third radiologist had nearly perfect concordance for composition, echogenicity, and shape and substantial concordance for margins and echogenic foci. The interobserver concordance was calculated for the two readings; the concordance was substantial except for shape in the first reading and for echogenicity and margins in the second reading, which had moderate concordance. CONCLUSIONS: The ACR TI-RADS classification system is reproducible.
Assuntos
Nódulo da Glândula Tireoide , Estudos Transversais , Humanos , Variações Dependentes do Observador , Estudos Retrospectivos , UltrassonografiaRESUMO
BACKGROUND: The production of carbapenem-hydrolyzing ß-lactamases is one of the most concerning resistance mechanisms since it eliminates the last therapeutic option against multidrug resistant microorganisms. AIM: To determine the production of KPC and NDM-1 type carbapenemases, using phenotypic and genotypic methods, in isolated enterobacteria in a clinical laboratory in the city of Maracay, Venezuela. METHODS: The production of carbapenemases was determined by phenotypic (according to the Malbrán algorithm) and genotypic methods (amplification of the blaNDM-1 and blaKPC genes by PCR) in clinical isolates of Enterobacteriaceae during the period March-August 2018. RESULTS: 605 Enterobacteriaceae of different species were identified, being Escherichia coli the strain with the highest percentage of isolation (61.3%), followed by Klebsiella pneumoniae (14.9%). Sixteen strains (2.64%) were positive for carbapenemases production: 13 strains of K. pneumoniae and three of the Enterobacter cloacae complex. PCR showed that 14 strains (87.5%) carry the blaNDM-1 gene and two strains (12.5%) the blaKPC gene; 100% agreement was observed between phenotypic determination and PCR for both groups of enzymes. CONCLUSIONS: The results of this study showed a higher incidence of metallo-ß-lactamase type NDM-1, which rapid dissemination and consequently difficult control has been cause of epidemiological alert. The identification of the type of enzyme would allow establishing more accurate management and control strategies in order to eradicate these pathogens.
Assuntos
Infecções por Enterobacteriaceae , Enterobacteriaceae , Antibacterianos , Proteínas de Bactérias/genética , Enterobacteriaceae/genética , Humanos , Klebsiella pneumoniae , Laboratórios , Testes de Sensibilidade Microbiana , Venezuela , beta-Lactamases/genéticaRESUMO
INTRODUCCIÓN: La producción de beta-lactamasas capaces de hidrolizar a los carbapenémicos es uno de los mecanismos de resistencia más preocupantes porque eliminan la última opción terapéutica frente a los microorganismos multi-resistentes. OBJETIVO: Determinar la producción de carbapenemasas tipo KPC y NDM-1, empleando métodos fenotípicos y genotípicos, en enterobacterias aisladas en un laboratorio clínico de la ciudad de Maracay, Venezuela. MÉTODOS: Se determinó la producción de carbapenemasas mediante métodos fenotípicos (según algoritmo de Malbrán) y genotípicos (amplificación de los genes blaNDM-1 y blaKPC por RPC) en enterobacterias aisladas en un laboratorio clínico durante el período marzo-agosto 2018. RESULTADOS: Se identificaron 605 enterobacterias de diferentes especies, siendo Escherichia coli la cepa con mayor porcentaje de aislamiento (61,3%), seguida por Klebsiella pneumoniae (14,9%). Diez y seis enterobacterias (2,64%) fueron positivas para la producción de carbapenemasas: 13 cepas de K. pneumoniae y tres del complejo Enterobacter cloacae. La RPC demostró que 14 cepas (87,5%) contienen el gen blaNDM-1 y dos (12,5%) el gen blaKPC; se observó 100% de concordancia entre la determinación fenotípica y la RPC para ambos grupos de enzimas. CONCLUSIONES: Los resultados mostraron mayor incidencia de la metalo-beta-lactamasa tipo NDM-1, reconocida como una alarma epidemiológica debido a que su rápida diseminación dificulta su control, por lo que la identificación del tipo de enzima permitiría establecer estrategias de manejo y control más certeras con la finalidad de erradicar a dichos patógenos.
BACKGROUND: The production of carbapenem-hydrolyzing beta-lactamases is one of the most concerning resistance mechanisms since it eliminates the last therapeutic option against multidrug resistant microorganisms. AIM: To determine the production of KPC and NDM-1 type carbapenemases, using phenotypic and genotypic methods, in isolated enterobacteria in a clinical laboratory in the city of Maracay, Venezuela. METHODS: The production of carbapenemases was determined by phenotypic (according to the Malbrán algorithm) and genotypic methods (amplification of the blaNDM-1 and blaKPC genes by PCR) in clinical isolates of Enterobacteriaceae during the period March-August 2018. RESULTS: 605 Enterobacteriaceae of different species were identified, being Escherichia coli the strain with the highest percentage of isolation (61.3%), followed by Klebsiella pneumoniae (14.9%). Sixteen strains (2.64%) were positive for carbapenemases production: 13 strains of K. pneumoniae and three of the Enterobacter cloacae complex. PCR showed that 14 strains (87.5%) carry the blaNDM-1 gene and two strains (12.5%) the blaKPC gene; 100% agreement was observed between phenotypic determination and PCR for both groups of enzymes. CONCLUSIONS: The results of this study showed a higher incidence of metallo-beta-lactamase type NDM-1, which rapid dissemination and consequently difficult control has been cause of epidemiological alert. The identification of the type of enzyme would allow establishing more accurate management and control strategies in order to eradicate these pathogens.
Assuntos
Humanos , Enterobacteriaceae/genética , Infecções por Enterobacteriaceae , Fenótipo , Proteínas de Bactérias/genética , Venezuela , beta-Lactamases/genética , Testes de Sensibilidade Microbiana , Genótipo , Klebsiella pneumoniae , Laboratórios , AntibacterianosRESUMO
INTRODUCTION AND AIMS: Surgery is the main treatment for gastric cancer. D2 radical gastrectomy is associated with a variable postoperative morbidity and mortality rate worldwide. The aim of the present study was to identify the risk factors associated with the postoperative morbidity and mortality of D2 radical gastrectomy, with curative intent, for gastric cancer. MATERIALS AND METHODS: A retrospective case series was conducted, in which the medical records were reviewed of patients with gastric cancer that underwent D2 radical gastrectomy, within the time frame of January 2014 and December 2018. Univariate and multivariate analyses were carried out to identify the risk factors related to postoperative morbidity and mortality within 90 days. RESULTS: The percentages of postoperative morbidity and mortality in 691 patients were 23.3% and 3.3%, respectively. In the multivariate analysis, age ≥ 70 years (OR=1.85, 95% CI: 1.25-2.76), ASA III-IV (OR=2.06, 95% CI: 1.28-3.34), total gastrectomy (OR=1.96, 95% CI:1.19-3.23), and pancreatosplenectomy (OR=5.41, 95% CI: 1.42-20.61) were associated with greater postoperative morbidity, and age≥70 years (OR=4.92, 95% CI:1.78-13.65), lower BMI (OR=0.81, 95% CI: 0.71-0.92), and hypoalbuminemia (OR=0.91, 95% CI: 0.85-0.98) were associated with greater mortality in distal and total D2 radical gastrectomy. CONCLUSIONS: D2 radical gastrectomy for gastric cancer was shown to be a safe treatment, with low postoperative morbidity and mortality rates. Age≥70 years, ASA III-IV, total gastrectomy, and pancreatosplenectomy were factors associated with a higher complication rate. Age≥70 years, lower BMI, and hypoalbuminemia were mortality predictors in distal and total radical gastrectomy.
RESUMO
AIM: Fluorescent semiconductor nanoparticles or quantum dots (QDs) have excellent properties as photosensitizers in photodynamic therapy. This is mainly a consequence of their nanometric size and the generation of light-activated redox species. In previous works, we have reported the low-cost biomimetic synthesis of glutathione (GSH) capped QDs (CdTe-GSH QDs) with high biocompatibility. However, no studies have been performed to determine their phototoxic effect. The aim of this work was to characterize the light-induced toxicity of green (QDs500 ) and red (QDs600 ) QDs in Escherichia coli, and to study the molecular mechanism involved. METHODS AND RESULTS: Photodegradation and reduction power of biomimetic QDs was determined to analyse their potential for radical generation. Escherichia coli cells were exposed to photoactivated QDs and viability was evaluated at different times. High toxicity was determined in E. coli cells exposed to photoactivated QDs, particularly QDs500 . The molecular mechanism involved in QDs phototoxicity was studied by determining Cd2+ -release and intracellular reactive oxygen species (ROS). Cells exposed to photoactivated QDs500 presented high levels of ROS. Cells exposed to photoactivated QDs500 presented high levels of ROS. Finally, to understand this phenomenon and the importance of oxidative and cadmium-stress in QDs-mediated phototoxicity, experiments were performed in E. coli mutants in ROS and Cd2+ response genes. As expected, E. coli mutants in ROS response genes were more sensitive than the wt strain to photoactivated QDs, with a higher effect in green-QDs500 . No increase in phototoxicity was observed in cadmium-related mutants. CONCLUSION: Obtained results indicate that light exposure increases the toxicity of biomimetic QDs on E. coli cells. The mechanism of bacterial phototoxicity of biomimetic CdTe-GSH QDs is mostly associated with ROS generation. SIGNIFICANCE AND IMPACT OF THE STUDY: The results presented establish biomimetic CdTe-GSH QDs as a promising cost-effective alternative against microbial infections, particularly QDs500 .
Assuntos
Compostos de Cádmio/farmacologia , Cádmio/metabolismo , Escherichia coli/efeitos dos fármacos , Fármacos Fotossensibilizantes/farmacologia , Pontos Quânticos/toxicidade , Telúrio/farmacologia , Antibacterianos/farmacologia , Materiais Biomiméticos/farmacologia , Biomimética , Viabilidade Microbiana , Mutação , Oxirredução/efeitos da radiação , Estresse Oxidativo/efeitos dos fármacos , Espécies Reativas de Oxigênio/metabolismoRESUMO
BACKGROUND: Ultrasonography (US) is the method of choice for evaluating thyroid nodules. In 2017, the American College of Radiology (ACR) created a classification system based on US characteristics. For the system to be adopted, it must be reproducible. OBJECTIVES: To determine the intraobserver and interobserver variability of the ACR TI-RADS. METHODS: Cross-sectional study; three radiologists with different levels of experience used the ACR TI-RADS to classify 100 nodules on two occasions one month apart, and we calculated the intraobserver and interobserver variability. RESULTS: Regarding intraobserver variability, the first radiologist had nearly perfect concordance for composition, echogenicity, shape, and margins and substantial concordance for echogenic foci; the second radiologist had nearly perfect concordance for composition, echogenicity, shape, and margins and substantial concordance for echogenic foci, and the third radiologist had nearly perfect concordance for composition, echogenicity, and shape and substantial concordance for margins and echogenic foci. The interobserver concordance was calculated for the two readings; the concordance was substantial except for shape in the first reading and for echogenicity and margins in the second reading, which had moderate concordance. CONCLUSIONS: The ACR TI-RADS classification system is reproducible.
RESUMO
BACKGROUND: There is an emerging field to put into practice new strategies for developing molecules with antimicrobial properties. In this line, several metals and metalloids are currently being used for these purposes, although their cellular effect(s) or target(s) in a particular organism are still unknown. Here we aimed to investigate and analyze Au3+ toxicity through a combination of biochemical and molecular approaches. RESULTS: We found that Au3+ triggers a major oxidative unbalance in Escherichia coli, characterized by decreased intracellular thiol levels, increased superoxide concentration, as well as by an augmented production of the antioxidant enzymes superoxide dismutase and catalase. Because ROS production is, in some cases, associated with metal reduction and the concomitant generation of gold-containing nanostructures (AuNS), this possibility was evaluated in vivo and in vitro. CONCLUSIONS: Au3+ is toxic for E. coli because it triggers an unbalance of the bacterium's oxidative status. This was demonstrated by using oxidative stress dyes and antioxidant chemicals as well as gene reporters, RSH concentrations and AuNS generation.
Assuntos
Escherichia coli/efeitos dos fármacos , Ouro/toxicidade , Nanopartículas Metálicas/toxicidade , Oxirredução/efeitos dos fármacos , Estresse Oxidativo/efeitos dos fármacosRESUMO
BACKGROUND: There Is an emerging field to put Into practice new strategies for developing molecules with antimicrobial properties. In this line, several metals and metalloids are currently being used for these purposes, although their cellular effect(s) or target(s) in a particular organism are still unknown. Here we aimed to investigate and analyze Au3+ toxicity through a combination of biochemical and molecular approaches. RESULTS: We found that Au3+ triggers a major oxidative unbalance in Escherichia coli, characterized by decreased intracellular thiol levels, increased superoxide concentration, as well as by an augmented production of the antioxidant enzymes superoxide dismutase and catalase. Because ROS production is, in some cases, associated with metal reduction and the concomitant generation of gold-containing nanostructures (AuNS), this possibility was evaluated in vivo and in vitro. CONCLUSIONS: Au3+ is toxic for E. coli because it triggers an unbalance of the bacterium's oxidative status. This was demonstrated by using oxidative stress dyes and antioxidant chemicals as well as gene reporters, RSH concentrations and AuNS generation.
Assuntos
Oxirredução/efeitos dos fármacos , Estresse Oxidativo/efeitos dos fármacos , Escherichia coli/efeitos dos fármacos , Nanopartículas Metálicas/toxicidade , Ouro/toxicidadeRESUMO
OBJECTIVE: Physiologically, blood melatonin levels decrease as a person ages and the older adult commonly presents with insomnia and other types of sleep disorders. Alternative therapies can be used to attenuate sleep disturbances. The aim of the present study was to analyze the effect of aromatherapy with lavender on serum melatonin levels in the noninstitutionalized older adult (OA). DESIGN AND SETTING: A pre-experimental, quantitative study with a pre-test - post-test design was conducted on 67 OAs that included both sexes. MAIN OUTCOME MEASURES: Serum melatonin levels were measured before and after eight sessions of aromatherapy with lavender that lasted 4 weeks. The results were expressed as mean⯱â¯standard deviation of melatonin levels (pg/ml). The differences were compared using the Student's t-test and statistical significance was set at a pâ¯≤â¯0.05. RESULTS: Blood melatonin levels significantly increased in the total population after the intervention with aromatherapy (pg/ml): 102.3⯱â¯33.4 VS 132.5⯱â¯42.3, pâ¯=â¯0.000004. There were significant differences in the pre-test and post-test phases in the women and men measured as separate groups (pâ¯=â¯0.00005 and pâ¯=â¯0.026), respectively. However, those differences were not observed when the measurements were compared between the two sexes, before (pâ¯=â¯0.64) or after (pâ¯=â¯0.31) the intervention. CONCLUSION: Aromatherapy with lavender essential oil similarly favors an increase in blood melatonin levels in both older adult men and women.
Assuntos
Aromaterapia/métodos , Lavandula , Melatonina/sangue , Óleos Voláteis/uso terapêutico , Óleos de Plantas/uso terapêutico , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Antecedentes: La cirugía ortognática es una opción terapéutica que busca parámetros de simetría, función masticatoria, respiratoria, e indirectamente mejorar el estado emocional de pacientes con anomalías dentofaciales. El instrumento Orthognathic Quality Of Life Questionnaire (OQLQ) permite realizar una evaluación subjetiva amplia y del nivel de calidad de vida pre y postquirúrgica, por lo que es necesario realizar el proceso de traducción al español y la adaptación cultural al contexto colombiano. Métodos: Posterior a la autorización del autor original se realizaron traducciones directas, obtención de una versión preliminar, traducciones inversas y una prueba piloto con 15 pacientes colombianos, mayores de 16 años, con anomalía dentofacial que asistieron al hospital de San José. Se aplicó la metodología del grupo de calidad de la European Organization for Research and Treatment of Cancer (EORTC) para garantizar que la versión en español de la escala sea equivalente conceptualmente a la original. Resultados: Las traducciones directas fueron consistentes, sin embargo, se hicieron ajustes para obtener la versión preliminar; las traducciones inversas fueron similares a la versión original de la escala. La prueba piloto, realizada en una muestra heterogénea de 15 pacientes, llevó al ajuste de la sintaxis de un ítem. De esta manera se obtuvo la versión en español del cuestionario que en fase posterior se validará. Conclusiones: La realización de este estudio permitió la adaptación de un cuestionario entendible en el contexto colombiano, garantizando una equivalencia lingüística y conceptual entre esta versión y la versión original
Introduction: Orthognathic surgery is a therapeutic option that seeks parameters of symmetry, masticatory function, breathing, and improves the emotional state of patients with dentofacial anomalies. The questionnaire Orthognathic Quality of Life Questionnaire (OQLQ) allows to make a subjective evaluation and the level of quality of life before and after surgery, so it is necessary to perform the translation into Spanish and the cultural adaptation to the Colombian context. Methods: After the authorization of the original author, direct translations were made obtaining a preliminary version, reverse translations and a pilot test was accomplished with 15 Colombian patients over 16 years of age with a dentofacial anomaly who attended the San José hospital in Bogotá. The methodology of the quality group of the European Organization for Research and Treatment of Cancer (EORTC) was applied to ensure that the Spanish version of the scale is conceptually equivalent to the original. Results: The direct translations were consistent, however, adjustments were made to obtain the preliminary version; the inverse translations were similar to the original version of the scale. The pilot test, carried out on a heterogeneous sample of 15 patients led to the adjustment of the syntax of one item. In this way, the Spanish version of the questionnaire was obtained. Conclusion: The realization of this study allowed the adaptation of an understandable questionnaire in the Colombian context, guaranteeing a linguistic and conceptual equivalence between this version and the original versión
Assuntos
Humanos , Masculino , Feminino , Adulto , Adulto Jovem , Adolescente , Comparação Transcultural , Cirurgia Ortognática , Qualidade de Vida , Deformidades Dentofaciais/cirurgia , Cirurgia Bucal/métodos , Má Oclusão/cirurgia , Tradução , Inquéritos e Questionários , Colômbia , Projetos Piloto , Articulação TemporomandibularRESUMO
INTRODUCCIÓN: La colecistectomía laparoscópica (CL) se considera el tratamiento quirúrgico recomendable para los pacientes portadores de esta entidad clínica. Uno de los beneficios es la pronta recuperación. Objetivos: El objetivo general de este estudio fue el de determinar la utilidad del régimen ambulatorio en pacientes sometidos a CL, bajo control perioperatorio. MATERIAL Y MÉTODOS: Se realizó un estudio de serie de casos en 150 pacientes programados para CL. Se analizaron las variables hemodinámicas en dos fases: Chi cuadrado, con p < 0,05. También se abordó el análisis del tiempo de duración de la intervención quirúrgica, el tiempo de recuperación posoperatoria y la valoración de Aldrete para cirugía ambulatoria. RESULTADOS: Fueron evaluados como: ASA I = 87 (58 %), ASA II = 63 (42 %). Las variables antropométricas: edad: X = 37,7 ± 15 DE. Peso: X = 70,88 ± 26. La duración de la cirugía fue: X = 66,5 ± 22 minutos. El tiempo de estancia posoperatoria fue: X = 5,55 ± 1,2 horas. Las variables hemodinámicas analizadas con T Pareada no muestran diferencias estadísticamente significativas. La valoración de Aldrete para pacientes ambulatorios fue de X = 19 puntos. CONCLUSIONES: El 100 % de los pacientes controló el dolor y fueron ambulatorios. De acuerdo con nuestros hallazgos, nos permitimos proponer a la colecistectomía laparoscópica para su adecuación en el régimen ambulatorio bajo manejo perioperatorio
INTRODUCTION: Laparoscopic Cholecystectomy (LC) is considered the recommended surgical treatment for patients with this clinical entity. One of the benefits is the speedy recovery.Objectivs: The general objective of this study was to determine the utility of the ambulatory regimen in patients undergoing CL, under perioperative control. MATERIAL AND METHOD: A case series study was carried out on 150 patients scheduled for LC. The hemodynamic variables were analyzed in two phases; when entering the unit and being discharged (through Paired T, with p < 0,05), the presence of pain (analysed visual scale) was also analyzed using Chi Square (X2), with p < 0,05. The analysis of the duration of the surgical intervention, the postoperative recovery time and the evaluation of Aldrete for Ambulatory Surgery were also addressed. RESULTS: They were evaluated as: ASA I = 87 (58 %), ASA II = 63 (42 %). The anthropometric variables: age: X = 37.7 years ± SD 15. Weight: X = 70,88 kg ± SD 26. The duration of the surgery was: X = 66.5 ± 22 minutes. The postoperative stay time was: X = 5.55 ± SD 1.2 hours. The hemodynamic variables analyzed with Paired T, do not show statistically significant differences. The Aldrete assessment for outpatients was X = 19 points. CONCLUSIONS: 100 % of the patients had pain control and were ambulatory. According to our findings, we allow us to propose laparoscopic cholecystectomy for its adaptation in the ambulatory regimen under perioperative managemen