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AIM: Skeletal-related events (SREs) are major bone complications that frequently occur in patients with solid tumors (ST) and bone metastases, and in patients with multiple myeloma (MM). SREs include pathological fracture, spinal cord compression, radiation to bone, and surgery to bone. Limited data are available regarding the burden of SREs in Latin America. We built an economic model to quantify the current and future economic burden of SREs among adults in four Latin American countries: Argentina, Brazil, Colombia, and Mexico. METHODS: A comprehensive literature review with a systematic search strategy was conducted to parameterize the economic burden of illness (BOI) model. Economic analyses were conducted using a prevalence-based model. Aggregate SRE costs obtained from country-specific sources were used. We also included patient productivity losses. Costs were expressed in 2020 USD for the total annual burden, annual burden per 1,000 at risk, and projected five-year burden. RESULTS: The estimated total number of SREs was 251,503 in 2020, amounting to a total annual cost of USD 1.4 billion. The total projected five-year cost was USD 6.9 billion. Annual costs were highest in Brazil (USD 779.1 million), followed by Mexico (USD 281.8 million), Argentina (USD 174.6 million), and Colombia (USD 120.1 million). The average financial burden per 1,000 at risk was greatest in Brazil (USD 3.6 million), followed by Mexico (USD 3.4 million), Colombia (USD 2.9 million), and Argentina (USD 2.7 million). CONCLUSION: Despite recommendations by medical societies for the use of bone-targeted agents in patients with solid tumors and bone metastasis or with multiple myeloma and bone lesions, a large proportion of patients at risk of experiencing SREs are not treated. Early detection of bone metastases and SREs and the use of the most effective preventative treatments are needed to decrease the clinical and economic burden of SREs in Latin America.
Assuntos
Custos de Cuidados de Saúde , Adulto , Argentina , Brasil/epidemiologia , Colômbia/epidemiologia , Humanos , América Latina/epidemiologia , México/epidemiologiaRESUMO
Two air-stable, isostructural, mononuclear six-coordinate manganese(II) and cobalt(II) oxamate complexes, [M(4-HOpa)2(H2O)2] [4-HOpa = N-4-hydroxyphenyloxamate; M= Mn2+ (1) or Co2+ (2)], exhibit field-induced slow magnetic relaxation. A bottleneck process is observed throughout the temperature range of 2-20 K for 1, while for 2, it dominates only at low temperatures (2-4 K). Additionally, the Raman process [n = 6.9(2)] is responsible for an increase in the relaxation time at higher temperatures to 2.
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Visceral Leishmaniasis is a chronic and lethal, parasitic disease. In the later infection stages, it is known that expressive hematological disorders can be observed, including changes in the frequency and phenotype of certain leukocytes. There is a lack of good prognostic indicators to characterize the on-goin clinical status of the patient. In this study, we have analyzed the frequency of monocyte subpopulations in mice infected with Leishmania major (L. major). Our results show a significant correlation between increased blood monocyte frequency and lesion development in both BALB/c and in the C57BL/6 mice infected with L. major. In BALB/c mice we observed a significant correlation between the frequency of GR1+ monocytes and lesion size. Furthermore, treatment of infected BALB/c mice with Anfotericin B, to resolve lesions, resulted in a lower frequency of GR1+ monocytes compared to untreated infected BALB/c mice. C57BL/6 infected mice, which normally resolve infections, show decreased numbers of monocytes during the healing phase of infection. The results indicate that disease severity can be predicted by analyzing monocyte frequency. Thus, we propose that the frequency of monocytes, can be used to define the severity of the disease as well as the success of the treatment in experimental leishmaniasis.
Assuntos
Anfotericina B/farmacologia , Leishmania major/isolamento & purificação , Leishmaniose Visceral/parasitologia , Monócitos/parasitologia , Animais , Antiprotozoários/farmacologia , Biomarcadores , Modelos Animais de Doenças , Feminino , Leishmania major/efeitos dos fármacos , Leishmaniose Visceral/tratamento farmacológico , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Endogâmicos C57BL , Monócitos/metabolismo , Índice de Gravidade de DoençaRESUMO
Objetivo: Relatar uma série de casos de doença moyamoya/síndrome de moyamoya (DMM/SMM) tratados por revascularização cerebral no período de 2001 a 2013. Método: Estudo retrospectivo de 12 pacientes portadores de DMM/SMM submetidos à revascularização cerebral. Resultados: Trêspacientes foram operados por meio de by-pass de alto fluxo, três com by-pass de baixo fluxo e seis por revascularização indireta (encefaloarteriossinangiose associada à galeossinangiose). Realizamosdurante o seguimento: análise da ocorrência de novos acidentes vasculares cerebrais (AVC), avaliação funcional (utilizando a Escala de Rankin Modificada) e das complicações cirúrgicas. O tempo de acompanhamento para o grupo de by-pass de alto fluxo foi de quatro a dez anos, para o grupo de baixo fluxo e revascularização indireta de três meses a três anos. Nenhum paciente apresentou outro AVC no hemisfério operado tampouco piora funcional. As taxas de morbimortalidade e de infecção foram nulas. Conclusão: A revascularização cerebral foi efetiva, prevenindo a ocorrência de novos AVC e evitando piora funcional.
Objective: To report a case series of moyamoya disease/moyamoya syndrome (DMM/SMM) treated by cerebral revascularization in the period 2001-2013. Method: Retrospective study of twelve patients with DMM/SMM submitted to cerebral revascularization. Results: Three patients were operated through high-flow by-pass, three with low flow by-pass and six with indirect revascularization (encephaloarterio-sinangiosis associated with galeo-sinangiosis). Analyzed during follow-up: the occurrence of new strokes, functional assessment (using the modified Rankin scale) and surgical complications. The follow up to the group of high-flow by-pass was 4-10 years for the group of low flow and indirect revascularization of three months to three years. No patient had another cerebrovascular accident (CVA) in the hemisphere operated nor functional worsening. Rates of morbidity and mortality and infection were nil. Conclusion: Cerebral revascularization was effective, preventing the occurrence of new strokesand preventing functional deterioration.
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Revascularização Cerebral/métodos , Acidente Vascular Cerebral/prevenção & controle , Estado Funcional , Doença de Moyamoya/cirurgia , Doença de Moyamoya/diagnóstico , Angiografia/métodos , Prontuários Médicos , Estudos Retrospectivos , Interpretação Estatística de Dados , Estudo ObservacionalRESUMO
BACKGROUND: Infection with parasite protozoa is a long-term health issue in tropical and subtropical regions throughout the world. The Toll-like receptor (TLR) signaling pathway is one of the first-responding defense systems against Leishmania. The aim of this study was to investigate the expression of TLR2 and TLR9 in jejunum and colon and its correlation with CD11c, CD11b, and CD14 receptors used as markers for dendritic cells and macrophages. METHODS: Twenty four dogs infected with Leishmania infantum were used in this study. Cytometry was carried out in lamina propria cells from jejunum and colon using markers for TLR2, TLR9, CD11b, CD11c and CD14. RESULTS: Cellular inflammatory exudate was diffuse in the mucosa and submucosa, predominately comprising mononuclear cells: plasma cells, macrophages, and lymphocytes. Despite the parasite load, microscopy showed no erosion was evident in the epithelial mucosa layers. The colon harbored more parasites than the jejunum. Flow cytometry revealed higher frequency of TLR2+ and CD11c+ dendritic cells in the colon than in the jejunum. Conversely, TLR9-expressing cells were more frequent in jejunum. Moreover, frequency of macrophages (CD11b+ and CD14+) expressing simultaneity TLR9 were lower in the colon than in jejunum, while CD11c+ cells predominated in the colon. Despite of the negative ELISA serum results, IL-10 and TNF-α were higher in jejunum than colon of infected animals. However, IL-4 was higher in colon than jejunum of infected animals. A higher expression these cytokines were demonstrated in infected dogs compared to uninfected dogs. CONCLUSIONS: There was no correlation between clinical signs and pathological changes and immunological and parasitological findings in the gastrointestinal tract in canine visceral leishmaniasis. However, jejunum showed a lower parasite load with increased frequency and expression of CD11b, TLR9, CD14/CD11b/TLR9 receptors and IL-10 and TNF-α cytokines. Conversely, the colon showed a higher parasite load along with increased frequency and expression of TLR2, CD11c receptors, and IL-4 cytokine. Thus, Leishmania infantum is able to interfere in jejunum increased expression of TLR2, TLR9, CD11b, CD14, CD14/CD11b/TLR9 receptors, IL-10, and TNF-α; and in colon increased expression of CD11c, TLR2, TLR9, CD11b, CD14 e, CD14/CD11b/TLR9 receptors, IL-10, and TNF-α.
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Colo/metabolismo , Doenças do Cão/imunologia , Doenças do Cão/parasitologia , Jejuno/metabolismo , Leishmania infantum/imunologia , Leishmaniose Visceral/veterinária , Receptor 2 Toll-Like/metabolismo , Receptor Toll-Like 9/metabolismo , Animais , Antígenos CD/metabolismo , Brasil , Colo/imunologia , Colo/parasitologia , Colo/patologia , Citocinas/metabolismo , Doenças do Cão/metabolismo , Doenças do Cão/patologia , Cães , Fluorescência , Jejuno/imunologia , Jejuno/parasitologia , Jejuno/patologia , Leishmania infantum/fisiologia , Leishmaniose Visceral/imunologia , Leishmaniose Visceral/parasitologia , Leishmaniose Visceral/patologia , Células Mieloides/metabolismo , ParasitosRESUMO
O presente trabalho teve como objetivo caracterizar o crescimento da parte aérea e do sistema radicular e a produção e partição da biomassa na planta em cultivo adensado na região agreste do RN / Brasil. Foram avaliados os efeitos do período seco e chuvoso sem e com adubação (200 kg / N / ha), em intervalos de corte de 240 dias. Para a caracterização do crescimento foram mensurados comprimento, largura, espessura, perímetro e área dos cladódios, sendo contabilizado e a distribuídos por ordem, por fim obteve-se o índice de área dos cladódios (IAC). Na determinação da distribuição das raízes e de sua biomassa foram utilizadas amostras com volume de 125,6 cm³, nas camadas de 0-10 e 10-20 cm de profundidade, distribuídos em linha, transição e entrelinha, na área útil da parcela. As produções de biomassa aérea e radicular para as avaliações no período seco (7,91; 1,3), chuvoso sem (8,76; 3,64) e com adubação (9,2; 4,02 t/ha), respectivamente. Os valores para relação raiz / parte aérea nos períodos foram de 0,16 (seco), 0,41(chuvoso sem) e 0,44 (chuvoso 200 kg / N / ha). O IAC médio foi de 0,70. O diâmetro radicular foi > 2,0 e o comprimento teve variação entre os períodos de 5,3 a 28,57 cm, sendo a superfície total média de 20,17 cm². Com isso observa-se que a palma, independente do tratamento aplicado, mobiliza grande parte dos recursos água e nutrientes para a parte aérea.
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Biomassa , Efeitos do Clima , Opuntia/crescimento & desenvolvimento , Estação Chuvosa , Estação SecaRESUMO
Com o objetivo de avaliar o comportamento de dezessete linhagens de soja em diferentes regiões de Estado do Tocantins (Central e Sul) foram conduzidos dois ensaios no ano agrícola 2007/08, sendo um na Área Experimental da Universidade Federal do Tocantins - UFT no município de Palmas-TO e outro na Área Experimental da Universidade Federal do Tocantins - UFT no município de Gurupi-TO. O delineamento experimental foi de blocos ao acaso com 34 tratamentos e três repetições, instalados em um esquema fatorial 17 X 2, constituído por dezessete cultivares de soja (CD 219RR, M-SOY 8585RR, M-S0Y 8787RR, M-SOY 8925RR, M-SOY 9056RR, P98R31, P98R62, P98R91, P98Y51, P99R01, TMG103RR, TMG106RR, TMG108RR, TMG115RR, TMG117RR, TMG121RR e BRSMG Valiosa) e duas localidades (Gurupi e Palmas). Foram avaliadas as características: altura de vagem; número de dias para o florescimento; número de dias para a maturação; altura das plantas e produção de grãos. Houve efeito significativo da interação local x cultivar para todas as características, exceto para número de dias para o florescimento. Os cultivares BRSMG Valiosa, M-SOY 8585 RR e TMG 106 RR alcançaram as maiores médias de produção.