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Although lung cancer (LC) is one of the most common and lethal tumors, only 15% of patients are diagnosed at an early stage. Smoking is still responsible for more than 85% of cases. Lung cancer screening (LCS) with low-dose CT (LDCT) reduces LC-related mortality by 20%, and that reduction reaches 38% when LCS by LDCT is combined with smoking cessation. In the last decade, a number of countries have adopted population-based LCS as a public health recommendation. Albeit still incipient, discussion on this topic in Brazil is becoming increasingly broad and necessary. With the aim of increasing knowledge and stimulating debate on LCS, the Brazilian Society of Thoracic Surgery, the Brazilian Thoracic Association, and the Brazilian College of Radiology and Diagnostic Imaging convened a panel of experts to prepare recommendations for LCS in Brazil. The recommendations presented here were based on a narrative review of the literature, with an emphasis on large population-based studies, systematic reviews, and the recommendations of international guidelines, and were developed after extensive discussion by the panel of experts. The following topics were reviewed: reasons for screening; general considerations about smoking; epidemiology of LC; eligibility criteria; incidental findings; granulomatous lesions; probabilistic models; minimum requirements for LDCT; volumetric acquisition; risks of screening; minimum structure and role of the multidisciplinary team; practice according to the Lung CT Screening Reporting and Data System; costs versus benefits of screening; and future perspectives for LCS.
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Neoplasias Pulmonares , Radiología , Cirugía Torácica , Humanos , Neoplasias Pulmonares/diagnóstico , Brasil/epidemiología , Detección Precoz del Cáncer/métodos , Tomografía Computarizada por Rayos X/métodos , Tamizaje MasivoRESUMEN
ABSTRACT Although lung cancer (LC) is one of the most common and lethal tumors, only 15% of patients are diagnosed at an early stage. Smoking is still responsible for more than 85% of cases. Lung cancer screening (LCS) with low-dose CT (LDCT) reduces LC-related mortality by 20%, and that reduction reaches 38% when LCS by LDCT is combined with smoking cessation. In the last decade, a number of countries have adopted population-based LCS as a public health recommendation. Albeit still incipient, discussion on this topic in Brazil is becoming increasingly broad and necessary. With the aim of increasing knowledge and stimulating debate on LCS, the Brazilian Society of Thoracic Surgery, the Brazilian Thoracic Association, and the Brazilian College of Radiology and Diagnostic Imaging convened a panel of experts to prepare recommendations for LCS in Brazil. The recommendations presented here were based on a narrative review of the literature, with an emphasis on large population-based studies, systematic reviews, and the recommendations of international guidelines, and were developed after extensive discussion by the panel of experts. The following topics were reviewed: reasons for screening; general considerations about smoking; epidemiology of LC; eligibility criteria; incidental findings; granulomatous lesions; probabilistic models; minimum requirements for LDCT; volumetric acquisition; risks of screening; minimum structure and role of the multidisciplinary team; practice according to the Lung CT Screening Reporting and Data System; costs versus benefits of screening; and future perspectives for LCS.
RESUMO O câncer de pulmão (CP) é uma das neoplasias mais comuns e letais no Brasil, e apenas 15% dos pacientes são diagnosticados nos estágios iniciais. O tabagismo persiste como o responsável por mais de 85% de todos os casos. O rastreamento do CP (RCP) por meio da TC de baixa dosagem de radiação (TCBD) reduz a mortalidade do CP em 20%, e, quando combinado com a cessação do tabagismo, essa redução chega a 38%. Na última década, diversos países adotaram o RCP como recomendação de saúde populacional. No Brasil, embora ainda incipiente, a discussão sobre o tema é cada vez mais ampla e necessária. Com o intuito de aumentar o conhecimento e estimular o debate sobre o RCP, a Sociedade Brasileira de Cirurgia Torácica, a Sociedade Brasileira de Pneumologia e Tisiologia e o Colégio Brasileiro de Radiologia e Diagnóstico por Imagem constituíram um painel de especialistas para elaborar as recomendações para o RCP. As recomendações aqui apresentadas foram baseadas em revisão narrativa da literatura, com ênfase em grandes estudos populacionais, em revisões sistemáticas e em recomendações de diretrizes internacionais, sendo construídas após ampla discussão pelo grupo de especialistas. Os temas revisados foram os seguintes: porque rastrear, considerações gerais sobre tabagismo, epidemiologia do CP, critérios de elegibilidade, achados incidentais, lesões granulomatosas, modelos probabilísticos, requisitos mínimos da TCBD, aquisições volumétricas, riscos do rastreamento, estrutura mínima e papel da equipe multidisciplinar, conduta segundo o Lung CT Screening Reporting and Data System (Lung-RADS), custos vs. benefícios e perspectivas do rastreamento.
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Antisepsis of the hands of medical personnel is one of the most important steps in the process of patient care, since direct contact can cause the cross-transfer of potentially pathogenic microorganisms at surgical sites. This study aimed to analyze the prevalence of microorganisms on the hands of 131 surgeons in a university hospital before the surgical procedure. Swabs were collected from each clinician's hands before and after handwashing. The samples were placed in a transport medium and immediately delivered to a private clinical analysis laboratory from São Luis-Maranhão. The microorganisms were identified by ionization source mass spectrometry and matrix-assisted laser desorption (MALDI-TOF), and antibiotic susceptibility tests (AST) were performed using the Vitek2 and Phoenix-BD automated system. The results showed a high frequency (100%) of microorganisms before handwashing, but after surgical antisepsis, the rate dropped significantly (p < 0.05) to 27.5%. The gram-positive species most detected were Staphylococcus spp. and Micrococcus luteus, representing 83.9%, followed by gram-negative species, Stenotrophomonas maltophilia, Acinetobacter baumanii, Pseudomonas aeruginosa, Pseudomonas gessardi, Pantoea septica, Serratia marcescens, and Burkholderia lata. The effectiveness of hand antisepsis was 72.5%, demonstrating that surgeons' hands are an important source of microorganisms that can cause infections in hospitalized patients in different care settings.
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Lifestyle changes regarding diet composition and exercise training have been widely used as a non-pharmacological clinical strategy in the treatment of obesity, a complex and difficult-to-control disease. Taking the potential of exercise in the browning process and in increasing thermogenesis into account, the aim of this paper was to evaluate the effect of resistance, aerobic, and combination training on markers of browning of white adipose tissue from rats with obesity who were switched to a balanced diet with normal calorie intake. Different types of training groups promote a reduction in the adipose tissue and delta mass compared to the sedentary high-fat diet group (HS). Interestingly, irisin in adipose tissues was higher in the resistance exercise (RE) and aerobic exercise (AE) groups compared to control groups. Moreover, in adipose tissue, the fibroblast growth factor 21 (FGF21), coactivator 1 α (PGC1α), and peroxisome proliferator-activated receptor gamma (PPARγ) were higher in response to resistance training RE compared with the control groups, respectively. Additionally, uncoupling protein 1 (UCP1) showed higher levels in response to group AE compared to the HS group. In conclusion, the browning process in white adipose tissue responds differently toward different training exercise protocols, with resistance and aerobic training efficient in activating different biomarkers of the browning process, upregulating irisin, FGF21, PGC1α, PPARγ, and UCP1 in WAT, which together may suggest an improvement in the thermogenic process in the adipose tissue. Considering the experimental conditions of the present investigation, we suggest future research to pave new avenues to be applied in clinical practices to combat obesity.
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Fibronectinas , PPAR gamma , Animales , Ratas , Coactivador 1-alfa del Receptor Activado por Proliferadores de Peroxisomas gamma , Obesidad/terapia , Tejido Adiposo , Proteína Desacopladora 1RESUMEN
Angiotensin-(1-7) is a peptide produced by different pathways, and regardless of the route, the angiotensin-converting enzyme 2 (ACE-2) is involved in one of the steps of its synthesis. Angiotensin-(1-7) binds to Mas receptors localized in different cells throughout the body. Whether angiotensin-(1-7) exerts any action in the urinary bladder (UB) is still unknown. We investigated the effects of intravenous and topical (in situ) administration of angiotensin-(1-7) on intravesical pressure (IP) and cardiovascular variables. In addition, the Mas receptors and ACE-2 gene and protein expression were analyzed in the UB. Adult female Wistar rats were anesthetized with 2% isoflurane in 100% O2 and submitted to the catheterization of the femoral artery and vein for mean arterial pressure (MAP) and heart rate (HR) recordings, and infusion of drugs, respectively. The renal blood flow was acquired using a Doppler flow probe placed around the left renal artery and the renal conductance (RC) was calculated as a ratio of Doppler shift (kHz) and MAP. The cannulation of the UB was performed for IP recording. We observed that angiotensin-(1-7) either administered intravenously [115.8 ± 28.6% angiotensin-(1-7) vs. -2.9 ± 1.3% saline] or topically [147.4 ± 18.9% angiotensin-(1-7) vs. 3.2 ± 2.8% saline] onto the UB evoked a significant (p < 0.05) increase in IP compared to saline and yielded no changes in MAP, HR, and RC. The marked response of angiotensin-(1-7) on the UB was also investigated using quantitative real-time polymerase chain reaction and western blotting assay, which demonstrated the mRNA and protein expression of Mas receptors in the bladder, respectively. ACE-2 mRNA and protein expression was also observed in the bladder. Therefore, the findings demonstrate that angiotensin-(1-7) acts in the UB to increase the IP and suggest that this peptide can be also locally synthesized in the UB.
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Trypanosomatids are flagellate protozoans that can infect several invertebrate and vertebrate hosts, including insects and humans. The three most studied species are the human pathogens Trypanosoma brucei, Trypanosoma cruzi and Leishmania spp. which are the causative agents of Human African Trypanosomiasis (HAT), Chagas disease and different clinical forms of leishmaniasis, respectively. These parasites possess complex dixenous life cycles, with zoonotic and anthroponotic stages, and are transmitted by hematophagous insects. To colonize this myriad of hosts, they developed mechanisms, mediated by virulence factors, to infect, propagate and survive in different environments. In insects, surface proteins play roles in parasite attachment and survival in the insect gut, whilst in the mammalian host, the parasites have a whole group of proteins and mechanisms that aid them invading the host cells and evading its immune system components. Many studies have been done on the impact of these molecules in the vertebrate host, however it is also essential to notice the importance of these virulence factors in the insect vector during the parasite life cycle. When inside the insect, the parasites, like in humans, also need to survive defense mechanisms components that can inhibit parasite colonization or survival, e.g., midgut peritrophic membrane barrier, digestive enzymes, evasion of excretion alongside the digested blood meal, anatomic structures and physiological mechanisms of the anterior gut. This protection inside the insect is often implemented by the same group of virulence factors that perform roles of immune evasion in the mammalian host with just a few exceptions, in which a specific protein is expressed specifically for the insect vector form of the parasite. This review aims to discuss the roles of the virulence molecules in the insect vectors, showing the differences and similarities of modes of action of the same group of molecules in insect and humans, exclusive insect molecules and discuss possible genetic events that may have generated this protein diversity.
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Enfermedad de Chagas , Parásitos , Trypanosoma cruzi , Animales , Enfermedad de Chagas/parasitología , Humanos , Insectos Vectores/parasitología , Insectos , Mamíferos , Proteínas de la Membrana , Trypanosoma cruzi/fisiología , Factores de Virulencia/genéticaRESUMEN
Trypanosoma brucei, Leishmania spp., and T. cruzi are flagellate protozoans of the family Trypanosomatidae and the causative agents of human African trypanosomiasis, leishmaniasis, and Chagas disease, respectively. These diseases affect humans worldwide and exert a significant impact on public health. Over the course of evolution, the parasites associated with these pathologies have developed mechanisms to circumvent the immune response system throughout the infection cycle. In cases of human infection, this function is undertaken by a group of proteins and processes that allow the parasites to propagate and survive during host invasion. In T. brucei, antigenic variation is promoted by variant surface glycoproteins and other proteins involved in evasion from the humoral immune response, which helps the parasite sustain itself in the extracellular milieu during infection. Conversely, Leishmania spp. and T. cruzi possess a more complex infection cycle, with specific intracellular stages. In addition to mechanisms for evading humoral immunity, the pathogens have also developed mechanisms for facilitating their adhesion and incorporation into host cells. In this review, the different immune evasion strategies at cellular and molecular levels developed by these human-pathogenic trypanosomatids have been discussed, with a focus on the key molecules responsible for mediating the invasion and evasion mechanisms and the effects of these molecules on virulence.
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Enfermedad de Chagas , Leishmaniasis , Trypanosoma brucei brucei , Trypanosoma cruzi , Humanos , VirulenciaRESUMEN
INTRODUÇÃO: O suspiro caracteriza-se pela realização de uma inspiração lenta e profunda, seguida de uma expiração lenta. Estudos sugerem que a adição de um suspiro por minuto em pacientes com síndrome do desconforto respiratório agudo, ventilados em PSV, melhora a oxigenação e a mecânica pulmonar. OBJETIVO: Avaliar o impacto da manobra de recrutamento alveolar através de suspiro na mecânica pulmonar e oxigenação em pacientes ventilados mecanicamente, além de verificar o impacto hemodinâmico e a incidência de intercorrências associadas à utilização da técnica. MATERIAIS E MÉTODOS: Estudo experimental com 17 pacientes em ventilação mecânica, apresentando relação entre pressão parcial de oxigênio alveolar e fração inspirada de oxigênio (PaO2/FiO2) inferior a 300mmHg. Avaliou-se dados respiratórios, de mecânica pulmonar e hemodinâmicos. Os dados foram coletados durante três períodos: antes do suspiro, imediatamente após e 15 minutos depois da técnica. Dois suspiros por minuto foram administrados utilizando pressão em vias aéreas limitada em 40cmH2O, durante um tempo inspiratório de quatro segundos. RESULTADOS: Após o suspiro, observou-se aumento da PaO2, pressão resistiva, complacência estática e relação PaO2/FiO2, além de diminuição da pressão de platô e pressão parcial de gás carbônico alveolar (PaCO2). Após 15 minutos da retirada do suspiro observou-se que a PaO2, pressão resistiva, complacência estática e relação PaO2/ FiO2 mantiveram-se acima do valor basal, enquanto que a pressão de platô manteve-se abaixo. Não foi observada alteração significante nas variáveis hemodinâmicas. CONCLUSÃO: O suspiro em pacientes ventilados mecanicamente foi capaz de melhorar a oxigenação e a mecânica pulmonar sem comprometer a estabilidade hemodinâmica.
INTRODUCTION: The sigh is characterized by a slow and deep inhalation, followed by a slow exhalation. Studies suggest that the addition of one breath per minute in patients with acute respiratory distress syndrome, ventilated on PSV, improves oxygenation and pulmonary mechanics. OBJECTIVE: Analyze the impact of the alveolar recruitment maneuver through breath in pulmonary mechanics and oxygenation in mechanically ventilated patients, in addition to checking the hemodynamic impact and the incidence of complications associated with the use of the technique. MATERIALS AND METHODS: Experimental study with 17 patients on mechanical ventilation, showing a relationship between partial pressure of alveolar oxygen and fraction of inspired oxygen (PaO2/FiO2) below 300mmHg. Respiratory, pulmonary mechanics, and hemodynamic data were evaluated. Data were collected during three periods: before sigh, immediately after, and 15 minutes after the technique. Two sighs per minute were administered using airways pressure limited to 40 cmH2O, during an inspiratory time of four seconds. RESULTS: After the sigh, there was an increase in PaO2, resistive pressure, static compliance, and PaO2/FiO2 ratio, in addition to a decrease in plateau pressure and partial pressure of alveolar carbon dioxide (PaCO2). After 15 minutes of sigh removal, it was observed that PaO2, resistive pressure, static compliance, and PaO2/ FiO2 ratio remained above the baseline, while the plateau pressure remained below. There was no significant change in hemodynamic variables. CONCLUSION: The sigh in mechanically ventilated patients was able to improve oxygenation and pulmonary mechanics without compromising hemodynamic stability
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Oxigenación , Respiración Artificial , Síndrome de Dificultad Respiratoria del Recién NacidoRESUMEN
BACKGROUND: Visceral leishmaniasis (VL) is a major neglected disease, potentially fatal, whose control is still impaired by inefficient and/or expensive treatment and diagnostic methods. The most promising approach for VL diagnosis uses serological assays with recombinant proteins, since they are more efficient and easier to perform. Tests developed for the human form of the disease, however, have not been shown to be efficient for its diagnosis in the canine host, the major reservoir for the American VL. METHODOLOGY/PRINCIPAL FINDINGS: Here, we describe a systematic approach aimed at the production of a new chimeric protein potentially able to be used for both human and canine VL diagnosis and based both on in silico gene design and experimental data. Starting from the previous identification of Leishmania infantum recombinant antigens efficient for the diagnosis of either human or canine VL, three of the best performing antigens were selected (Lci2, Lci3 and Lci12). After a preliminary evaluation validating the chimeric approach, DNA fragments encoding predicted antigenic regions from each protein, enriched with repeats, were joined in various combinations to generate a total of seventeen chimeric genes optimized for prokaryotic expression. These were assessed for optimal expression and purification yield, with four chimeric proteins being efficiently produced. Their diagnostic potential was then evaluated through ELISA assays with sera from VL afflicted humans and dogs. After two rounds of gene design, the results showed high levels of sensitivity for the best chimeric protein, named Q5, in humans (82%) and dogs (100%) with 100% specificity in comparison with healthy controls. A single non-specific reaction was seen with serum from individuals with tegumentary leishmaniasis. CONCLUSION: The newly described chimeric protein is potentially useful for the detection of both humans and dogs afflicted with VL, with its use in rapid tests necessary for validation as a new diagnostic tool.
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Enfermedades de los Perros/diagnóstico , Leishmaniasis Visceral/veterinaria , Pruebas Serológicas/veterinaria , Secuencia de Aminoácidos , Animales , Antígenos de Protozoos/química , Enfermedades de los Perros/sangre , Perros , Escherichia coli/metabolismo , Regulación de la Expresión Génica , Humanos , Leishmaniasis Visceral/sangre , Leishmaniasis Visceral/diagnóstico , Proteínas Protozoarias/química , Proteínas Recombinantes/química , Proteínas Recombinantes/metabolismo , Sensibilidad y Especificidad , Pruebas Serológicas/métodos , TranscriptomaRESUMEN
BACKGROUND: The leishmaniasis are parasitic diseases caused by protozoans of the genus Leishmania, highly divergent eukaryotes, characterized by unique biological features. To survive in both the mammalian hosts and insect vectors, these pathogens make use of a number of mechanisms, many of which are associated with parasite specific proteases. The metalloprotease GP63, the major Leishmania surface antigen, has been found to have multiple functions required for the parasite's survival. GP63 is encoded by multiple genes and their copy numbers vary considerably between different species and are increased in those from the subgenus Viannia, including L. braziliensis. RESULTS: By comparing multiple sequences from Leishmania and related organisms this study sought to characterize paralogs in silico, evaluating their differences and similarities and the implications for the GP63 function. The Leishmania GP63 genes are encoded on chromosomes 10, 28 and 31, with the genes from the latter two chromosomes more related to genes found in insect or plant parasites. Those from chromosome 10 have experienced independent expansions in numbers in Leishmania, especially in L. braziliensis. These could be clustered in three groups associated with different mRNA 3' untranslated regions as well as distinct C-terminal ends for the encoded proteins, with presumably distinct expression patterns and subcellular localizations. Sequence variations between the chromosome 10 genes were linked to intragenic recombination events, mapped to the external surface of the proteins and predicted to be immunogenic, implying a role against the host immune response. CONCLUSIONS: Our results suggest a greater role for the sequence variation found among the chromosome 10 GP63 genes, possibly related to the pathogenesis of L. braziliensis and closely related species within the mammalian host. They also indicate different functions associated to genes mapped to different chromosomes. For the chromosome 10 genes, variable subcellular localizations were found to be most likely associated with multiple functions and target substrates for this versatile protease.
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Simulación por Computador , Variación Genética , Evasión Inmune/genética , Leishmania braziliensis/genética , Leishmania braziliensis/inmunología , Metaloendopeptidasas/genética , Secuencia de Aminoácidos , Cromosomas/genética , Epítopos de Linfocito B/inmunología , Evolución Molecular , Leishmania braziliensis/patogenicidad , Metaloendopeptidasas/química , Recombinación Genética , Homología de Secuencia de Ácido Nucleico , Virulencia/genéticaRESUMEN
A órbita é uma escavação óssea no crânio, que tem função de apoio e proteção ao bulbo do olho, seus vasos e nervos. Ela é uma pirâmide óssea composta por 7 ossos que compõem quatro paredes: um teto, uma base, parede lateral e medial; são eles o osso esfenoidal, etmoide, maxila, palatino, placa orbital do osso frontal, zigomático e lacrimal. O nervo óptico é composto pelas células ganglionares da retina e comunica o globo ocular ao cérebro. Pode ser dividido em 4 partes que possuem comprimentos diferentes, num total de 50mm, divididos em partes intraocular, intraorbital, intracanalicular e intracraniano. Tanto a órbita quanto o nervo óptico devem estar dentro dos parâmetros anatômicos de normalidade e qualquer alteração nesse padrão é uma possível causa de perda ou diminuição da acuidade visual. Uma dessas possíveis causas da diminuição da acuidade poderia ser uma anormalidade anatômica dos ossos orbitais, causando uma diminuição ou distorção do espaço orbital. Outra hipótese pode ser uma desproporção entre as dimensões do nervo óptico e o forame óptico, causando uma compressão e consequente lesão nervosa, ou até mesmo a existência de uma desproporção entre a cavidade orbital e os diâmetros do nervo óptico. Para compreender a relação entre a perda da acuidade visual e as alterações anatômicas citadas é essencial estabelecer o padrão de normalidade da órbita e do nervo óptico e suas dimensões. Para o tipo de análise proposta, a tomografia computadorizada helicoidal pode fornecer esses padrões de normalidade. Com esse intuito, foram observados 50 exames em cortes axiais representando a cavidade orbital, o canal óptico e o nervo óptico que foram identificados e mensurados pelo programa OsiriX. O comprimento da cavidade da órbita apontou para o lado direito, média de 39,40mm e, lado esquerdo, média de 38,40mm. O comprimento da parte intraorbital do nervo óptico para o olho direito, média 23,90mm e o olho esquerdo, média de 23,60mm. O diâmetro do canal óptico do lado direito alcançou um valor médio de 4,900mm e do lado esquerdo obteve uma média de 4,290mm. Por meio da análise do presente estudo foi possível estabelecer valores numéricos para o padrão de normalidade, permitindo investigações causais posteriores.
The orbit is a bone digging in the skull, which has a supporting and protective function to the eye bulb, its vessels and nerves. It is a bone pyramid composed of 7 bones that consists of four walls: a ceiling, a base, lateral and medial wall. They are the sphenoid bone, ethmoid, maxilla, palatine, orbital plaque of the frontal bone, zygomatic and lacrimal. The optic nerve is composed of the ganglion cells of the retina, and they communicate the ocular globe to the cortex. It can be divided into 4 parts that present different lengths, being a total of 50mm, divided into intraocular, intraorbital, intracanalicular and intracranial parts. Both the orbit and the optic nerve must be within the anatomical parameters of normality, and any change in this pattern is a possible cause of loss or decrease of visual acuity. One of these possible causes of decreased acuity could be an anatomical abnormality of the orbital bones, causing a decrease or distortion of the orbital space. Another hypothesis may be a disproportion between the dimensions of the optic nerve and the optic foramen, causing a compression and consequent nerve damage, or even the existence of a disproportion between the orbital cavity and the diameters of the optic nerve. To understand the relationship between loss of visual acuity and the anatomical changes cited, it is essential to establish the normality of the orbit and optic nerve and its dimensions. For analysis proposed, helical computerized tomography can provide these normality patterns. For this purpose, 50 exams were performed on axial sections representing the orbital cavity, optic canal and optic nerve that were identified and measured by the OsiriX program. The cavity length of the orbit was to the right side, mean of 39.40mm and left side: mean of 38.40mm. The length of the intraorbital portion of the optic nerve to the right eye, mean 23.90mm and the left eye, mean of 23.60mm. The diameter of the optical channel on the right side reached an average value of 4.900mm and the left side obtained an average of 4.290mm. Through the analysis of the present study it was possible to establish numerical values for the normality pattern allowing further causal investigations.
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Nervio Óptico , Tomografía Computarizada Espiral , ÓrbitaRESUMEN
Current strategies for the control of zoonotic visceral leishmaniasis (VL) rely on its efficient diagnosis in both human and canine hosts. The most promising and cost effective approach is based on serologic assays with recombinant proteins. However, no single antigen has been found so far which can be effectively used to detect the disease in both dogs and humans. In previous works, we identified Leishmania infantum antigens with potential for the serodiagnosis of VL. Here, we aimed to expand the panel of the available antigens for VL diagnosis through another screening of a genomic expression library. Seven different protein-coding gene fragments were identified, five of which encoding proteins which have not been previously studied in Leishmania and rich in repetitive motifs. Poly-histidine tagged polypeptides were generated from six genes and evaluated for their potential for diagnosis of VL by ELISA (Enzyme Linked ImmunoSorbent Assay) with sera from infected humans and dogs. None of those was valid for the detection of human VL (26-52% sensitivity) although their performance was increased in the canine sera (48-91% sensitivity), with one polypeptide useful for the diagnosis of canine leishmaniasis. Next, we assayed a mixture of three antigens, found to be best for human or canine VL, among 13 identified through different screenings. This "Mix" resulted in similar levels of sensitivity for both human (84%) and canine (88%) sera. With improvements, this validates the use of multiple proteins, including antigens identified here, as components of a single system for the diagnosis of both forms of leishmaniasis.
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Antígenos de Protozoos/inmunología , Leishmaniasis Visceral/diagnóstico , Leishmaniasis Visceral/veterinaria , Proteínas Recombinantes/inmunología , Pruebas Serológicas/métodos , Secuencia de Aminoácidos , Animales , Antígenos de Protozoos/química , Perros , Electroforesis en Gel de Poliacrilamida , Ensayo de Inmunoadsorción Enzimática , Humanos , Leishmania infantum/inmunología , Leishmaniasis Visceral/sangre , Péptidos/metabolismo , Análisis de Secuencia de ProteínaRESUMEN
ABSTRACT Paraendodontic surgeries have been increasingly used to solve problems related to failures in conventional endodontic treatment. Better anatomical knowledge of the structures as well as the development of techniques and materials involved has resulted in substantial paraendodontic surgery increase and success. In some cases, teeth endodontic treatment highly benefits treatment accomplishment. This report describes a case of an endodontic treatment complemented by paraendodontic surgery in periapical region of 21, 22 and 23 of a female patient who had been treated at the clinic of the Brazilian Dental Association Dentistry - in the city of Cascavel, State of Parana, Brazil. The case presents a 12-month follow-up for the resolution of painful symptoms, lesion reduction, and bone formation. Literature review was performed regarding paraendodontic surgery in order to assess the determining factors, failure causes and procedure indications/contraindications, as well.
RESUMO A cirurgia paraendodôntica tem sido cada vez mais utilizada para sanar problemas inerentes aos insucessos no tratamento endodôntico convencional. O melhor conhecimento anatômico das estruturas envolvidas bem como a evolução das técnicas e dos materiais proporcionou um aumento significativo da utilização desta técnica e, por conseguinte seu maior sucesso. O tratamento endodôntico primário de um elemento dentário pode atingir altos índices de sucesso. Tornando-se, portanto, imprescindível para se atingir o sucesso do tratamento de alguns casos. Neste trabalho descreve-se um caso de tratamento endodôntico complementado por cirurgia paraendodôntica em região periapical dos elementos dentais 21, 22 e 23 de paciente do gênero feminino que foi tratada na Clínica de Odontologia da Associação Brasileira de Odontologia - Regional de Cascavel, Pr. O caso apresenta acompanhamento de 12 meses com resolução da sintomatologia dolorosa, redução da lesão e neoformação óssea. Foi realizada uma discussão com revisão da literatura sobre a cirurgia paraendodôntica avaliando os fatores determinantes, causas de insucessos, indicações e contraindicações do procedimento.
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The effects of different light quality treatments on in vitro growth and multiplication of sugarcane (RB867515) were investigated. The plantlets were cultivated on MS medium containing 1.3 µM 6-benzylaminopurine (BAP), and exposed to five light treatments: three combinations of blue/red LED (70:30, 50:50, 30:70), white-LED and fluorescent lamps, during 24 days. Among the LED light treatments, blue/red combination in 50:50 proportions proved to have the best results for stem length, fresh mass, leaf number and shoot multiplication. Higher content of photosynthetic pigments was also obtained with LEDs. Results suggested that the light quality emitted by LEDs was suitable for plant growth and development and it may be used as alternative and economic light source for micropropagation of sugarcane variety under analysis.
Foram investigados os efeitos de diferentes tratamentos de qualidade da luz sobre o crescimento e multiplicação in vitro de cana-de-açúcar (RB867515). As plantas foram cultivadas em meio MS contendo 1,3 µ M de 6-benzilaminopurina (BAP) e expostas a cinco tratamentos de luz: três combinações de LED azul/vermelho (70:30, 50:50, 30:70), LED branco e lâmpadas fluorescentes, durante 24 dias. Entre os tratamentos de luz de LED, a combinação azul/vermelho na proporção 50:50 apresentou os melhores resultados para altura, massa fresca, número de folhas e multiplicação de brotos. Maior teor de pigmentos fotossintéticos também foi obtido com a utilização de LEDs. Os resultados sugerem que a qualidade da luz emitida pelos LEDs foi adequada para o crescimento e desenvolvimento das plantas e pode ser utilizada como fonte de luz alternativa e econômica para a micropropagação da variedade de cana-de-açúcar estudada.
Asunto(s)
Saccharum/crecimiento & desarrollo , Técnicas In Vitro/métodos , LuzRESUMEN
The recent development of core/shell engineering of rare earth doped luminescent nanoparticles has ushered a new era in fluorescence thermal biosensing, allowing for the performance of minimally invasive experiments, not only in living cells but also in more challenging small animal models. Here, the potential use of active-core/active-shell Nd(3+)- and Yb(3+)-doped nanoparticles as subcutaneous thermal probes has been evaluated. These temperature nanoprobes operate in the infrared transparency window of biological tissues, enabling deep temperature sensing into animal bodies thanks to the temperature dependence of their emission spectra that leads to a ratiometric temperature readout. The ability of active-core/active-shell Nd(3+)- and Yb(3+)-doped nanoparticles for unveiling fundamental tissue properties in in vivo conditions was demonstrated by subcutaneous thermal relaxation monitoring through the injected core/shell nanoparticles. The reported results evidence the potential of infrared luminescence nanothermometry as a diagnosis tool at the small animal level.
Asunto(s)
Mediciones Luminiscentes/instrumentación , Nanopartículas/química , Neodimio/química , Termómetros , Iterbio/química , Administración Cutánea , Animales , Temperatura Corporal , Rayos Infrarrojos , Luminiscencia , Ratones , Nanopartículas/administración & dosificación , Neodimio/administración & dosificación , Fenómenos Fisiológicos de la Piel , Iterbio/administración & dosificaciónRESUMEN
The effects of different light quality treatments on in vitro growth and multiplication of sugarcane (RB867515) were investigated. The plantlets were cultivated on MS medium containing 1.3 μM 6-benzylaminopurine (BAP), and exposed to five light treatments: three combinations of blue/red LED (70:30, 50:50, 30:70), white-LED and fluorescent lamps, during 24 days. Among the LED light treatments, blue/red combination in 50:50 proportions proved to have the best results for stem length, fresh mass, leaf number and shoot multiplication. Higher content of photosynthetic pigments was also obtained with LEDs. Results suggested that the light quality emitted by LEDs was suitable for plant growth and development and it may be used as alternative and economic light source for micropropagation of sugarcane variety under analysis.(AU)
Foram investigados os efeitos de diferentes tratamentos de qualidade da luz sobre o crescimento e multiplicação in vitro de cana-de-açúcar (RB867515). As plantas foram cultivadas em meio MS contendo 1,3 μM de 6-benzilaminopurina (BAP) e expostas a cinco tratamentos de luz: três combinações de LED azul/vermelho (70:30, 50:50, 30:70), LED branco e lâmpadas fluorescentes, durante 24 dias. Entre os tratamentos de luz de LED, a combinação azul/vermelho na proporção 50:50 apresentou os melhores resultados para altura, massa fresca, número de folhas e multiplicação de brotos. Maior teor de pigmentos fotossintéticos também foi obtido com a utilização de LEDs. Os resultados sugerem que a qualidade da luz emitida pelos LEDs foi adequada para o crescimento e desenvolvimento das plantas e pode ser utilizada como fonte de luz alternativa e econômica para a micropropagação da variedade de cana-deaçúcar estudada.(AU)
Asunto(s)
Análisis Espectral , Análisis Espectral/veterinaria , Saccharum/efectos adversos , Saccharum/crecimiento & desarrollo , 24444RESUMEN
OBJETIVO: Verificar a presença do sinal de sedimentação nos pacientes com canal lombar estreito (CLE) comparando-os com os pacientes sem CLE. MÉTODOS: Realizado um estudo retrospectivo, transversal e descritivo. Realizada a revisão dos processos imagiológicos dos pacientes com CLE operados entre 1 de janeiro de 2008 e 31 de dezembro de 2009, comparando-os com os dos pacientes sem CLE observados em consulta externa. Os pacientes foram divididos em dois grupos: grupo I com 34 pacientes com diagnóstico de CLE. Critérios diagnósticos: existência de lombalgia e/ou claudicação neurogénica e/ou radiculopatia, associados a um diâmetro anteroposterior do canal menor que 10mm e grupo II com 40 pacientes observados em consulta externa por lombalgia sem clínica de CLE. Foi feita a medicação do diâmetro do canal e verificada a presença do sinal de sedimentação entre D12 a S1. RESULTADOS: O sinal da sedimentação foi positivo em 31 dos 34 pacientes do grupo I (91,2%), em dois destes 31 pacientes apenas abaixo da estenose. Este sinal não foi encontrado em nenhum paciente do segundo grupo. Verifica-se uma correlação estatisticamente significativa entre as variáveis "diâmetro do canal" e a "presença do sinal da sedimentação" (p<0.01) no grupo de pacientes com canal lombar estreito. CONCLUSÕES: O diagnóstico de CLE nem sempre é fácil atendendo à frequente dissonância entre os achados clínicos e imagiológicos. O sinal de sedimentação é positivo em pacientes com CLE entre os níveis L1 e L5, podendo ser um sinal válido para complementar o diagnóstico de CLE.
OBJECTIVE: To verify the presence of the sedimentation sign in patients with lumbar spinal stenosis (LSS) in comparison to those without LSS. METHODS: Retrospective, cross-sectional and descriptive study. Review of the imaging processes of patients with LSS operated between January 1, 2008 and December 31, 2009, comparing with patients without LSS observed in outpatient consultations. Patients were divided into two groups: group I had 34 patients with a diagnosis of LSS. Diagnostic criteria: existence of low back pain and/or neurogenic claudication and/or radiculopathy, associated with an anteroposterior canal diameter of less than 10 mm. Group II had 40 patients observed in outpatient consultations for low back pain without clinical LSS. The canal diameter was measured and the presence of the sedimentation sign between D12 and S1 was verified. RESULTS: A positive sedimentation sign was identified in 31 of the 34 patients in group I (91.2%); only below the stenosis in two of these 31 patients. The sign was not observed in the patients in group II. A statistically significant correlation was observed between the variables "canal diameter" and "presence of sedimentation sign" (p < 0.01) in the group of patients with lumbar spinal stenosis. CONCLUSION: The diagnosis of LSS is not always easy due to the frequent dissonance between the clinical and imaging findings. The sedimentation sign is positive in patients with LSS between L1 and L5 and can be a valid sign to complement the diagnosis of LSS.
OBJETIVO: Verificar la presencia de la señal de sedimentación en los pacientes con Canal Lumbar Estrecho (CLE), comparándolos con los pacientes sin CLE. MÉTODOS: Realizado un estudio retrospectivo, transversal y descriptivo. Realizada la revisión de los procesos de imagen de los pacientes con CLE operados entre el 1ro de enero de 2008 y el 31 de diciembre de 2009, en comparación con los pacientes sin CLE observados en las consultas externas. Creamos dos grupos de pacientes: grupo I, 34 pacientes con diagnóstico de CLE. Criterios de diagnósticos: existencia de lumbago y/o claudicación neurogénica y/o radiculopatía, asociados a un diámetro del canal menor de 10 mm. Grupo II, 40 pacientes observados en consultas externas por lumbago sin clínica de CLE. Se realizó la medicación del diámetro del canal y fue verificada la presencia de la señal de sedimentación entre D12 y S1. RESULTADOS: La señal de la sedimentación fue positiva en 31 de los 34 pacientes del grupo I (91,2 %), en dos de estos 31 pacientes solamente por debajo de la estenosis. Esta señal no se encontró en ningún paciente del segundo grupo. Se verificó una correlación, estadísticamente significativa, entre las variables "diámetro del canal" y la "presencia de la señal de la sedimentación" (p<0,01) en el grupo de pacientes con canal lumbar estrecho. CONCLUSIONES: El diagnóstico de CLE no siempre es fácil atendiendo a la frecuente discrepancia entre los hallazgos clínicos y de imagen. La señal de sedimentación es positiva en pacientes con CLE entre los niveles L1 y L5, pudiendo ser una señal válida para complementar el diagnóstico de CLE.
Asunto(s)
Humanos , Espectroscopía de Resonancia Magnética , Diagnóstico por Imagen , Cauda Equina , Sedimentación , Constricción PatológicaRESUMEN
Objetivo: o presente trabalho tem como principal objetivo analisar a presença de desvio apical de acordo com a técnica de instrumentação e os instrumentos utilizados durante o preparo biomecânico em canais radiculares. Métodos:realizou-se testes in vitro com os dois tipos de preparo(alternado e contínuo) em canais radiculares, em um total de 24 unidades dentárias divididas em dois grupos de acordo com os tipos de preparos biomecânicos realizados.Conclusão: ao final do experimento, pode-se observar que não ocorreu diferença significativa entre os dois tipos de instrumentais das técnicas empregadas. Isso sugere uma maior atenção ao preparo alternado, que, devido ao seu baixo custo, pode ser incluído nos CEOs (Centros de Especialidades Odontológicas) do Ministério da Saúde do Governo Federal do Brasil