RESUMEN

BACKGROUND: Latent tuberculosis (LTB) is a condition where the patient is infected with Mycobacterium tuberculosis but does not develop active TB. There's a possibility of tuberculosis (TB) activation following the introduction of anti-TNFs. OBJECTIVE: To assess the risk of biological therapy inducing LTB during inflammatory bowel diseases (IBD) treatment over 15 years in a high-risk area in Brazil. METHODS: A retrospective study of an IBD patients' database was carried out in a private reference clinic in Brazil. All patients underwent TST testing and chest X-ray prior to treatment, and once a year after starting it. Patients were classified according to the Montreal stratification and risk factors were considered for developing TB. RESULTS: Among the analyzed factors, age and gender were risk factors for LTB. DC (B2 and P) and UC (E2) patients showed a higher number of LTB cases with statistical significance, what was also observed for adalimumab and infliximab users, compared to other medications, and time of exposure to them favored it significantly. Other factors such as enclosed working environment have been reported as risk. CONCLUSION: The risk of biological therapy causing LTB is real, so patients with IBD should be continually monitored. This study reveals that the longer the exposure to anti-TNFs, the greater the risk. BACKGROUND: •Rate of infection (tuberculosis) in Brazilians IBD private patients: follow-up 15 years. BACKGROUND: •Patients treated with immunosuppressants and/or anti-TNFs have a higher risk of developing opportunistic infections, among them the most common is latent tuberculosis or even active tuberculosis. BACKGROUND: •Similar risks may be noted in patients with inflammatory bowel diseases (IBDs). BACKGROUND: •This study reveals that the longer the exposure to anti-TNFs, the greater the risk for de IBD patients. BACKGROUND: •The study demonstrated the importance of monitoring these patients permanently and continuously.

Asunto(s)

RESUMEN

Layered lead halide perovskites have attracted much attention as promising materials for a new generation of optoelectronic devices. To make progress in applications, a full understanding of the basic properties is essential. Here, we study 2D-layered (BA)2PbX4 by using different halide anions (X = I, Br, and Cl) along with quantum confinement. The obtained cell parameter evolution, supported by experimental measurements and theoretical calculations, indicates strong lattice distortions of the metal halide octahedra, breaking the local inversion symmetry in (BA)2PbCl4, which strongly correlates with a pronounced Rashba spin-splitting effect. Optical measurements reveal strong photoluminescence quenching and a drastic reduction in the PL quantum yield in this larger band gap compound. We suggest that these optical results are closely related to the appearance of the Rashba effect due to the existence of a local electric dipole. The results obtained in ab initio calculations showed that the (BA)2PbCl4 possesses electrical polarization of 0.13 µC/cm2 and spin-splitting energy of about 40 meV. Our work establishes that local octahedra distortions induce Rashba spin splitting, which explains why obtaining UV-emitting materials with high PLQY is a big challenge.

RESUMEN

ABSTRACT Background: Latent tuberculosis (LTB) is a condition where the patient is infected with Mycobacterium tuberculosis but does not develop active TB. There's a possibility of tuberculosis (TB) activation following the introduction of anti-TNFs. Objective: To assess the risk of biological therapy inducing LTB during inflammatory bowel diseases (IBD) treatment over 15 years in a high-risk area in Brazil. Methods: A retrospective study of an IBD patients' database was carried out in a private reference clinic in Brazil. All patients underwent TST testing and chest X-ray prior to treatment, and once a year after starting it. Patients were classified according to the Montreal stratification and risk factors were considered for developing TB. Results: Among the analyzed factors, age and gender were risk factors for LTB. DC (B2 and P) and UC (E2) patients showed a higher number of LTB cases with statistical significance, what was also observed for adalimumab and infliximab users, compared to other medications, and time of exposure to them favored it significantly. Other factors such as enclosed working environment have been reported as risk. Conclusion: The risk of biological therapy causing LTB is real, so patients with IBD should be continually monitored. This study reveals that the longer the exposure to anti-TNFs, the greater the risk.

RESUMO Contexto: A tuberculose latente (TBL) é uma condição em que o paciente está infectado com Mycobacterium tuberculosis, mas não desenvolve tuberculose (TB) ativa. Existe a possibilidade de ativação da TB após a introdução de anti-TNFs. Objetivo: Avaliar o risco da terapia biológica induzindo TBL durante o tratamento de doenças inflamatórias intestinais (DII) ao longo de 15 anos em uma área de alto risco no Brasil. Métodos: Foi realizado um estudo retrospectivo de um banco de dados de pacientes com DII em uma clínica privada de referência no Brasil. Todos os pacientes foram submetidos a teste de TST e radiografia de tórax antes do tratamento e uma vez por ano após seu início. Os pacientes foram classificados de acordo com a estratificação de Montreal e foram considerados fatores de risco para o desenvolvimento de TB. Resultados: Entre os fatores analisados, a idade e o sexo foram fatores de risco para TBL. Os pacientes com doença de Crohn' (B2 e P) e colite ulcerativa (E2) apresentaram maior número de casos de TBL com significância estatística, o que também foi observado para usuários de adalimumab e infliximab, em comparação com outros medicamentos, e o tempo de exposição a eles favoreceu significativamente. Outros fatores, como ambiente de trabalho fechado, foram relatados como riscos. Conclusão: O risco da terapia biológica causar TBL é real, por isso os pacientes com DII devem ser monitorados continuamente. Este estudo revela que quanto maior a exposição aos anti-TNFs, maior o risco.

RESUMEN

The present study aimed to evaluate the antibacterial and modulatory activity of the Turnera subulate methyl extract in isolation or in combination with aminoglycoside antibiotics, using the microdilution method. The Turnera subulata methyl extract was used in isolation in the antibacterial assays and in combination with antibiotics in the modulation assays. All tests were performed in triplicates. The Turnera subulata methyl extract presented both antibacterial and antibiotic-modulatory effects in vitro, in isolation and in association with aminoglycosides. The extract activity depends on the bacterial strain and may be associated with the presence of tannins and flavonols. However, further studies are required to characterize the Turnera subulata potential for the development of new drugs against multiresistant bacteria.

Asunto(s)

RESUMEN

INTRODUCTION: Cancer patients are at risk for severe complications related to the underlying malignancy or its treatment and, therefore, usually require admission to intensive care units (ICU). Here, we evaluated the clinical characteristics and outcomes in this subgroup of patients. MATERIALS AND METHODS: Secondary analysis of two prospective cohorts of cancer patients admitted to ICUs. We used multivariable logistic regression to identify variables associated with hospital mortality. RESULTS: Out of 2,028 patients, 456 (23%) had cancer-related complications. Compared to those without cancer-related complications, they more frequently had worse performance status (PS) (57% vs 36% with PS≥2), active malignancy (95% vs 58%), need for vasopressors (45% vs 34%), mechanical ventilation (70% vs 51%) and dialysis (12% vs 8%) (P<0.001 for all analyses). ICU (47% vs. 27%) and hospital (63% vs. 38%) mortality rates were also higher in patients with cancer-related complications (P<0.001). Chemo/radiation therapy-induced toxicity (6%), venous thromboembolism (5%), respiratory failure (4%), gastrointestinal involvement (3%) and vena cava syndrome (VCS) (2%) were the most frequent cancer-related complications. In multivariable analysis, the presence of cancer-related complications per se was not associated with mortality [odds ratio (OR) = 1.25 (95% confidence interval, 0.94-1.66), P = 0.131]. However, among the individual cancer-related complications, VCS [OR = 3.79 (1.11-12.92), P = 0.033], gastrointestinal involvement [OR = 3.05 (1.57-5.91), P = <0.001] and respiratory failure [OR = 1.96(1.04-3.71), P = 0.038] were independently associated with in-hospital mortality. CONCLUSIONS: The prognostic impact of cancer-related complications was variable. Although some complications were associated with worse outcomes, the presence of an acute cancer-related complication per se should not guide decisions to admit a patient to ICU.

Asunto(s)

RESUMEN

Objetivo: Avaliar se existe relação entre os diferentes procedimentos odontológicos e o comportamento infantil. Material e método: Em crianças com idade entre oito e dez anos, pacientes da Clínica de Odontopediatria do Curso de Odontologia da Universidade Federal do Ceará foram utilizados para aferição de dor e desconforto: o questionário CFSS-DS, a classificação de Frankl, a Escala Visual Analógica, a Escala SOM, a Escala de Ansiedade da Face, e aferição dos batimentos cardíacos da criança. A amostra foi estratificada de acordo os procedimentos clínicos, grupo 1: procedimentos invasivos e grupo 2: procedimentos não invasivos. Resultados: No questionário CFSS-DS a amostra ficou caracterizada como de pouco medo para os dois grupos. Foi encontrado maior desconforto para procedimentos invasivos na Escala Analógica Facial, Escala Analógica Visual e Escala SOM. Por outro lado não foi encontrado um padrão para os batimentos cardíacos dentro de cada grupo. Verificou-se que não há grande diferença entre procedimentos invasivos e procedimentos não invasivos do ponto de vista comportamental da criança. Pois, nos parâmetros utilizados, como: Batimentos Cardíacos, Escala Visual Analógica, Escala Analógica Facial Depois e Escala SOM, houve uma sensação de desconforto em ambos os procedimentos. Percebe-se então, a necessidade constante da utilização de técnicas de controle e condicionamento comportamental e psicológico para a realização do atendimento ao paciente pediátrico.

Objective: To evaluate whether there is a relationship between the different dental procedures and child behavior. Methods: In children aged eight and ten, patients of the Clinic of Pediatric Dentistry of the Federal University of Ceará Dentistry Course were used to measure pain and discomfort: the CFSS-DS questionnaire, the Frankl classification, the scale Visual Analog, Scale SOM, the Face Anxiety Scale, and measurement of the child's heartbeat. The sample was stratified by clinical procedures, group 1: invasive procedures and group 2: non-invasive procedures. Results: In the CFSS-DS questionnaire sample was characterized as little scared for both groups. It found greater discomfort for invasive procedures in Facial Analogue Scale, Visual Analogue Scale and Scale SOM. On the other hand it was not found a pattern to the heartbeat within each group. Conclusion: It was found that no great difference between invasive and non-invasive procedures behavioral point of view of the child. For the used parameters, such as: Heart Rate, Visual Analogue Scale, Analog Scale and Scale Facial After SOM, there was a sense of discomfort in both procedures. It can be seen then, the constant need to use control techniques and behavioral and psychological conditioning for the realization of care to pediatric patients.

RESUMEN

It is described the case of an inflammatory maxillary sinus process, with both torpid evolution and post-traumatic etiology. The surgery proved the existence of a foreign body lodged in the maxillary sinus.

Asunto(s)

RESUMEN

A case of rhinophyma, surgically treated, is reported, for being a process with low incidence and for its big size.

Asunto(s)

RESUMEN

Until recently, [3H]-thymidine incorporation, DNA analysis by flow cytometry, and cell doubling times have been the main methods of studying tumour cell kinetics. All these techniques are laborious, expensive, and difficult to perform in a routine diagnostic laboratory. This study examined fresh frozen sections from 31 prostatic biopsy specimens with the hybridoma antibody Ki-67, a marker of proliferating cells, using a modified avidin-biotin-peroxidase complex technique. The percentage of glandular cells decorated by this antibody, representing the growth fraction, was determined for both benign and malignant samples. Benign prostatic glands showed an average Ki-67 score of 4 per cent, significantly less than the 16.3 per cent mean growth fraction found in prostatic carcinomas. There was a significant correlation between the tumour growth fraction as assessed by Ki-67 staining, and the histological grade. A positive correlation was also found between the Ki-67 score and the intensity of staining, and a definite trend was noted between the Ki-67 score and the tumour clinical stage. Ki-67 promises to be a useful marker in determining the prognosis of prostatic cancer.

Asunto(s)

RESUMEN

We report a case of ureteral intussusception owing to well differentiated transitional cell carcinoma. The occurrence and radiological features of ureteral intussusception are discussed.

Asunto(s)

RESUMEN

Small focal rheumatoid nodule-like granulomas have been noted in the prostatic chips from 11 repeat transurethral resections (TUR) in 10 patients. The lesions are situated in the prostatic stroma and are characterized by a central zone of fibrinoid necrosis, a peripheral palisade of fibroblasts and histiocytes and variable numbers of lymphocytes and giant cells. These granulomas are only noted in prostatic tissue from repeat TURs, are not evident in the original TUR tissue and probably have an iatrogenic basis. As yet, they appear to be of no clinical significance, but the entity is not well recognized, and the surgical pathologist should guard against over-interpretation of the lesions.

Asunto(s)

RESUMEN

During January and February 1980 there was an epidemic of urethral strictures at the Royal Adelaide Hospital. These strictures all occurred in men undergoing coronary artery bypass surgery. The strictures were inflammatory in nature and the patients were assessed to determine if a common aetiological factor could be identified. Follow-up has reaffirmed that inflammatory strictures are difficult to treat. Only half of the patients responded to conservative treatment; the only factor which appeared to influence the outcome of treatment was the time taken for a patient to present because of his symptoms.

Asunto(s)

RESUMEN

An 18-year-old female was found to be hypertensive on routine medical examination. Further investigation disclosed persistent hypokalaemia and elevated plasma renin activity in peripheral venous blood. Segmental renal vein sampling with assay of blood samples located the source of excess renin secretion in the lower mid-zone of the left kidney. This localization was not confirmed by either angiography or by palpation of the exposed kidney before nephrectomy but macroscopic examination of the freshly sectioned kidney revealed a small tumour in the region suggested by renal vein sampling. The tumour had the morphologic pattern fo an haemangiopericytoma with abundant ultrastructural specific granules and very high renin activity by tissue assay. Plasma renin activity fell precipitously after nephrectomy and remained very low for the first week. Although the immediate post-operative blood pressure fell to normal, hypertension recurred temporarily and was associated with elevated plasma aldosteron, producing a syndrome similar to primary aldosteronism. All variables returned to normal without specific therapy and hypertension has not subsequently recurred.

Asunto(s)

Asunto(s)

Asunto(s)

Asunto(s)

Asunto(s)

Asunto(s)

Asunto(s)