RESUMO
OBJECTIVE: : To explore the medical literature on techniques of tissue and sperm handling after surgical retrieval for intracytoplasmic sperm injection (ICSI). METHODS: : A search was performed in PubMed and Google Scholar databases, according to a modified Preferred Reporting Items for Systemic Reviews and Meta-Analyses (PRISMA) guideline, considering the studies investigating tissue handling and sperm selection techniques for ICSI. RESULTS: : Overall, 42 articles were included in this study, investigating sample handling, methods for sperm selection, and the use of chemical compounds to improve sperm motility and fertilisation rates. CONCLUSION: : The ideal sperm handling method should provide a high sperm count, high vitality and appropriate sperm function, without side-effects. In this review the most common and useful techniques are described and the best combination strategies discussed in clinical scenarios.
RESUMO
OBJETIVO: Para melhorar as propriedades mecânicas e imunogênicas, o glutaraldeído é utilizado no tratamento do pericárdio bovino que é utilizado em biopróteses. A liofilização do pericárdio bovino tratado com glutaraldeído diminui os radicais aldeído, com provável redução do potencial para calcificação. O objetivo deste estudo é avaliar os efeitos da liofilização em biopróteses valvares de pericárdio bovino como mecanismo protetor na diminuição da disfunção estrutural valvar. MÉTODOS: Foi realizado o implante de biopróteses de pericárdio bovino tratado com glutaraldeído, liofilizadas ou não, em carneiros de 6 meses de idade, sendo os animais eutanasiados com 3 meses de seguimento. As biopróteses foram implantadas em posição pulmonar, com auxílio de circulação extracorpórea. Um grupo controle e outro grupo liofilizado foram avaliados quanto ao gradiente ventrículo direito/artéria pulmonar (VD/AP) no implante e explante; análise quantitativa de cálcio; inflamação; trombose e pannus. O nível de significância estabelecido foi de 5%. RESULTADOS: O gradiente médio VD/AP, no grupo controle, no implante, foi 2,04 ± 1,56 mmHg e, no grupo de liofilização, foi 6,61 ± 4,03 mmHg. No explante, esse gradiente aumentou para 7,71 ± 3,92 mmHg e 8,24 ± 6,2 mmHg, respectivamente, nos grupos controle e liofilização. O teor de cálcio médio, após 3 meses, nas biopróteses do grupo controle foi 21,6 ± 39,12 µg Ca+2/mg de peso seco, em comparação com um teor médio de 41,19 ± 46,85 µg Ca+2/mg de peso seco no grupo liofilizado (P = 0,662). CONCLUSÃO: A liofilização de próteses valvares com pericárdio bovino tratado com glutaraldeído não demonstrou diminuição da calcificação neste experimento.
OBJECTIVE: Glutaraldehyde is currently used in bovine pericardium bioprosthesis to improve mechanical and immunogenic properties. Lyophilization is a process that may decrease aldehyde residues in the glutaraldehyde treated pericardium decreasing cytotoxicity and enhancing resistance to calcification. The aim of this study is to evaluate bioprosthetic heart valves calcification in adolescent sheep and to study the potential of lyophilization as a mechanism to protect calcification. METHODS: Two groups were evaluated: a control group in which a bovine pericardium prosthetic valve was implanted in pulmonary position and a lyophilized group in which the bovine pericardium prosthetic valve was lyophilized and further implanted. Sixteen sheeps 6 months old were submitted to the operation procedure. After 3 months the sheeps were euthanized under full anesthesia. RESULTS: Six animals of the control group reached 95.16 ± 3.55 days and six animals in the lyophilized group reached 91.66 ± 0.81 days of postoperative evolution. Two animals had endocarditis. Right ventricle/pulmonary artery (RV/PA) mean gradient, in the control group, at the implantation was 2.04 ± 1.56 mmHg, in the lyophilization group, the RV/PA mean gradient, at the implantation was 6.61 ± 4.03 mmHg. At the explantation it increased to 7.71 ± 3.92 mmHg and 8.24 ± 6.25 mmHg, respectively, in control and lyophilization group. The average calcium content, after 3 months, in the control group was 21.6 ± 39.12 µg Ca+2/mg dry weight, compared with an average content of 41.19 ± 46.85 µg Ca+2/mg dry weight in the lyophilization group (P=0.662). CONCLUSION: Freeze drying of the bovine pericardium prosthesis in the pulmonary position could not demonstrate calcification mitigation over a 3 month period although decreased inflammatory infiltration over the tissue.
Assuntos
Animais , Bovinos , Bioprótese/efeitos adversos , Calcinose/prevenção & controle , Próteses Valvulares Cardíacas/efeitos adversos , Teste de Materiais/métodos , Pericárdio/química , Artéria Pulmonar/cirurgia , Calcinose/patologia , Fixadores/farmacologia , Liofilização/métodos , Glutaral/farmacologia , Modelos Animais , Pericárdio/ultraestrutura , Distribuição Aleatória , Ovinos , Estatísticas não ParamétricasRESUMO
OBJECTIVE: Glutaraldehyde is currently used in bovine pericardium bioprosthesis to improve mechanical and immunogenic properties. Lyophilization is a process that may decrease aldehyde residues in the glutaraldehyde treated pericardium decreasing cytotoxicity and enhancing resistance to calcification. The aim of this study is to evaluate bioprosthetic heart valves calcification in adolescent sheep and to study the potential of lyophilization as a mechanism to protect calcification. METHODS: Two groups were evaluated: a control group in which a bovine pericardium prosthetic valve was implanted in pulmonary position and a lyophilized group in which the bovine pericardium prosthetic valve was lyophilized and further implanted. Sixteen sheep 6 months old were submitted to the operation procedure. After 3 months the sheep were euthanized under full anesthesia. RESULTS: Six animals of the control group reached 95.16 ± 3.55 days and six animals in the lyophilized group reached 91.66 ± 0.81 days of postoperative evolution. Two animals had endocarditis. Right ventricle/pulmonary artery (RV/PA) mean gradient, in the control group, at the implantation was 2.04 ± 1.56 mmHg, in the lyophilization group, the RV/PA mean gradient, at the implantation was 6.61 ± 4.03 mmHg. At the explantation it increased to 7.71 ± 3.92 mmHg and 8.24 ± 6.25 mmHg, respectively, in control and lyophilization group. The average calcium content, after 3 months, in the control group was 21.6 ± 39.12 µg Ca+2/mg dry weight, compared with an average content of 41.19 ± 46.85 µg Ca+2/mg dry weight in the lyophilization group (P=0.662). CONCLUSION: Freeze drying of the bovine pericardium prosthesis in the pulmonary position could not demonstrate calcification mitigation over a 3 month period although decreased inflammatory infiltration over the tissue.
Assuntos
Bioprótese/efeitos adversos , Calcinose/prevenção & controle , Próteses Valvulares Cardíacas/efeitos adversos , Teste de Materiais/métodos , Pericárdio/química , Artéria Pulmonar/cirurgia , Animais , Calcinose/patologia , Bovinos , Fixadores/farmacologia , Liofilização/métodos , Glutaral/farmacologia , Modelos Animais , Pericárdio/ultraestrutura , Distribuição Aleatória , Ovinos , Estatísticas não ParamétricasRESUMO
Talvez mais do que qualquer outro câncer, o câncer de mama expõe a paciente não só a um abalo emocional e psicológico, mas também a uma possível modificação da autoestima. A comunicação do câncer de mama ocorre em um momento importante do diagnóstico da enfermidade. Esta revisão tem o objetivo de verificar se existe um padrão de comunicação do diagnóstico de câncer de mama e avaliar os aspectos envolvidos. Foi realizada uma busca nas bases de dados Medline, Lilacs e Biblioteca Cochrane por meio dos descritores breast neoplasms, disclosure, persuasive communication, diagnosis e physician-patient relations, através da qual foram selecionados oito estudos. Dentre estes, seis abordaram aspectos da comunicação; dois classificam tipos de comunicação; e um analisa as pacientes após o diagnóstico. A conclusão é que não há um padrão único e fixo para a comunicação do diagnóstico do câncer de mama tendo em vista a imensa complexidade e variabilidade de preferências das pacientes.
Perhaps more than any other cancer, breast cancer not only exposes the patient to a psychological and emotional upheaval, but also a possible modification of self-esteem. The communication of breast cancer occurs at an important time of diagnosis of disease. This review aims to establish whether there is a communications standard for the diagnosis of breast cancer and evaluate the issues involved. Was searched in Medline, Lilacs and Cochrane Library using the keywords "breast neoplasms," "disclosure," "persuasive communication", "diagnosis" and "physician-patient relations, through which eight studies were selected . Six of these dealt with aspects of communication, two classified types of communication, and one examines the patients after diagnosis. The conclusion is that there is a single, fixed standard for the communication of the diagnosis of breast cancer in view of the immense complexity and variability of preferences of patients.
Assuntos
Humanos , Feminino , Diagnóstico Clínico , Neoplasias da Mama/diagnóstico , Relações Médico-Paciente , Barreiras de Comunicação , Neoplasias da Mama/psicologiaRESUMO
HIV-1 from infected subjects has been characterized in order to provide a more accurate view of the strains that are currently found in a given region. In this report, we focused on characterizing the pol gene diversity obtained from newly diagnosed patients in Santos metropolitan area, Brazil. This region is composed of nine cities and an international port. Analysis of the 33 samples revealed that 22 strains belonged to subtype B, 4 to subtype F, and 2 to subtype C; 5 strains were B/F recombinants. Our results demonstrated that 18.2% of samples were primary antiretroviral resistance genotypic mutations, with high-level resistance to reverse transcriptase inhibitors in both subtypes B and F and in recombinant forms B/F. Our data revealed that the primary antiretroviral resistance genotypic mutations should be carefully investigated in developing countries with widespread access to antiretrovirals, such as Brazil.