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Cancer remains a significant global health concern, with mortality rates steadily rising and prompting an urgent search for effective treatments. This study focuses on the medicinal properties of plants from the Phyllanthus genus, specifically Phyllanthus amarus and Phyllanthus niruri, which have shown promise in traditional medicine. Through bioguided fractionation using preparative high-performance liquid chromatography (HPLC), bioactive compounds were isolated and identified using ultra-performance liquid chromatography coupled to time-of-flight mass spectrometry (UHPLC-QTOF-MSE) and nuclear magnetic resonance (NMR) spectroscopy. Chemometric analyses such as principal component analysis (PCA) aided in understanding metabolite distribution. Biological assays demonstrated cytotoxic activities of specific fractions against cancer cell lines, notably the PhyN 4n fraction from P. niruri, which induced S-phase cell cycle arrest and apoptosis in HL60 cells. These findings underscore the anticancer potential of Phyllanthus species and lay the groundwork for future drug development efforts. The study's integration of advanced analytical techniques, chemometrics, and biological assays provides valuable insights for harnessing natural products in the fight against cancer.
Assuntos
Antineoplásicos Fitogênicos , Apoptose , Ensaios de Seleção de Medicamentos Antitumorais , Metabolômica , Phyllanthus , Phyllanthus/química , Humanos , Antineoplásicos Fitogênicos/farmacologia , Antineoplásicos Fitogênicos/química , Antineoplásicos Fitogênicos/isolamento & purificação , Apoptose/efeitos dos fármacos , Cromatografia Líquida de Alta Pressão , Extratos Vegetais/química , Extratos Vegetais/farmacologia , Extratos Vegetais/isolamento & purificação , Linhagem Celular Tumoral , Proliferação de Células/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Relação Dose-Resposta a DrogaRESUMO
Introducción: Se suele aplicar en pacientes con SARS-CoV-2 el decúbito prono (DP) prolongadamente, pues ha demostrado beneficios para solventar la falta de equipos de ventilación mecánica; sin embargo, también tiende a producir lesiones por presión (LPP) en regiones anatómicas no experimentadas en otras prácticas. Objetivo: Calcular la incidencia de LPP en el paciente crítico de COVID-19 en DP, describir características de los pacientes y las lesiones. Metodología: Estudio observacional, descriptivo, de carácter transversal con enfoque retrospectivo. La recolección de datos se realizó en un hospital de tercer nivel de la Ciudad de México, incluyó 230 pacientes que desarrollaron LPP posterior a su ingreso. Se analizó el expediente electrónico y los registros de la clínica de heridas, la recolección de datos se generó en Excel y el análisis estadístico en el programa SPSS. Resultados: La incidencia fue de 18.05%, las LPP con esfacelo corresponden al 33.9% y las de necrosis al 40%. La localización anatómica en pabellón auricular, pómulos y tórax fue de 36.1% y 46.5% fueron lesiones de categoría III con afectación de las estructuras musculares. La correlación con el IMC demostró que pacientes con sobrepeso presentaron mayor incidencia de LPP con fibrina y esfacelo en un 60.3%. Limitación del estudio: No se consideraron variables como la carga de trabajo de enfermería. Originalidad: Esta investigación no ha sido postulada previamente en ningún órgano editorial. Conclusiones: La incidencia coincide con estudios en otros países, por lo que es necesario estandarizar las acciones para la prevención de LPP y reducir su incidencia.
Introduction: Prolonged prone decubitus (PD) is usually applied in patients with SARSCoV2, as it has shown benefits to solve the lack of mechanical ventilation equipment; however, it also tends to produce pressure injuries (PI) in anatomical regions not experienced in other practices. Objective: To calculate the incidence of PI in the critical patient of COVID-19 in PD, describe patient characteristics and injuries. Methodology: Observational, descriptive, cross-sectional study with retrospective approach. Data collection was performed in a tertiary level hospital in Mexico City, including 230 patients who developed PI after admission. The electronic file and wound clinic records were analyzed, data collection was generated in Excel and statistical analysis in the SPSSs program. Results: The incidence was 18.05%, PI with slough corresponded to 33.9% and those with necrosis to 40%. The anatomical location in the pinna, cheekbones and thorax was 36.1% and 46.5% were category III lesions with involvement of muscular structures. Correlation with BMI showed that overweight patients had a higher incidence of PI with fibrin and sphacel in 60.3%. Limitation of the study: variables such as nursing workload were not considered. Originality: This research has not been previously postulated in any editorial body. Conclusions: The incidence coincides with studies in other countries, so it is necessary to standardize actions for the prevention of PI and reduce its incidence.
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Ferimentos e Lesões , Pneumonia , Pronação , Estado TerminalRESUMO
Introducción: La patología otorrinolaringológica (ORL) presenta alta incidencia en atención primaria, alcanzando hasta 49% de las consultas, sin embargo, la pandemia por SARS-CoV-2 repercutió de manera transversal en los servicios sanitarios, pudiendo haber influido en el perfil de consulta, por lo que se requiere un análisis para la elaboración de estrategias que permitan asegurar la atención sanitaria ante eventos de esta magnitud. Objetivo: Analizar el perfil de consulta libre por patología ORL ambulatoria en un centro médico privado en La Serena durante los años 2019 y 2020. Material y Método: Estudio analítico de corte transversal sobre consultas ambulatorias durante los años 2019 y 2020 realizadas en un centro privado de atención abierta en La Serena. Se estimaron frecuencias en números absolutos y proporciones, estimación de promedios y medianas. Resultados: Durante 2019 hubo un total de 11.932 consultas y en 2020 hubo 9.576. Se observó un predominio de sexo femenino en las consultas de 51% en ambos años. La mediana en 2019 fue de 35 años y en 2020 de 39 años. En 2020 las patologías con mayor consulta fueron nariz (44%), oído (37%) y faringolaringe (14%). Existió un aumento significativo en la consulta por patología cocleovestibular durante 2020. Conclusión: En 2020 hubo una disminución del 19,7% de las consultas dado, probablemente, a las restricciones de movilidad y aforos. Existió un aumento significativo en la proporción de consultas por patologías cocleovestibulares, como vértigo periférico, hipoacusia súbita y tinnitus, atribuido probablemente al estrés emocional generado por la pandemia.
Introduction: Otolaryngological (ENT) pathology presents high incidence in primary care reaching up to 49% of morbidity consultations, however, the pandemic by SARS-CoV-2 had a transversal impact on health services, and may have influenced the consultation profile, so an analysis is required for the development of strategies to ensure health care in the face of events of this magnitude. Aim: To analyze the profile of spontaneous consultation for outpatient ENT pathology in a medical center in La Serena city during 2019 and 2020. Material and Methods: Cross-sectional analytical study of outpatient consultations during the years 2019 and 2020 performed in a private open care center in the commune of La Serena. Frequencies were estimated in absolute numbers and proportions; averages and medians were estimated. Results: During 2019 there were a total of 11,932 consultations and in 2020 there were 9,576. There was a predominance of female sex in the consultations of 51%. The median in 2019 was 35 years and in 2020 it was 39 years. In 2020, the pathologies with the highest number of consultations were nose (44%), ear (37%) and laryngopharynx (14%). There was an increase in consultation for cochleovestibular pathology during 2020. Conclusion: In 2020 there was a 19.7% of consultation decrease probably due to mobility and capacity restrictions. There was a significant increase in the proportion of consultations for cochleovestibular pathologies such as peripheral vertigo, hearing loss and tinnitus, probably attributed to the emotional stress generated by the pandemic.
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Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Otolaringologia , Assistência Ambulatorial , COVID-19 , Distribuição de Qui-Quadrado , Chile/epidemiologia , IncidênciaRESUMO
Resumen Introducción: Las enfermedades otorrinolaringológicas presentan una alta prevalencia en la población, lo que obliga continuamente a estudiar sus características epidemiológicas. Una forma de estimarlo a nivel país es a través de los egresos hospitalarios. Objetivo: Describir las principales causas de egresos hospitalarios por enfermedades otorrinolaringológicas a nivel nacional durante el año 2018. Material y Método: Estudio transversal donde se describen las distintas frecuencias de las principales causas de egresos hospitalarios por causa otorrinolaringológica en todo Chile durante el año 2018. Datos obtenidos del Departamento de Estadísticas e Información en Salud (DEIS). Resultados: Se incluyeron 64.715 egresos con una mediana de edad de 22 años. Las patologías con mayor cantidad de egresos fueron la enfermedad crónica de amígdalas y adenoides (28,4%), patología rinosinusal (23,3%), neoplasias de cabeza y cuello (15,2%) y oído (7,8%). Conclusión: La enfermedad crónica de amígdalas y adenoides persiste como la patología con más egresos. Emergen en importancia enfermedades neoplásicas y diagnósticos relacionados con mejora de calidad de vida. Existen errores de codificación de diagnósticos que requieren discusión dentro de la especialidad para mejorar la calidad del registro.
Abstract Introduction: Otolaryngological diseases have a high prevalence in the population, creating the need to continuously study their epidemiological characteristics. One way to estimate prevalence at the country level, is to check hospital discharges. Aim: To describe the main causes of hospital discharges due to otolaryngological diseases at the Chilean level during 2018. Material and Method: Cross-sectional study describing the different frequencies of the main causes of hospital discharge due to otolaryngological diseases throughout Chile during 2018. Data obtained from the Department of Health Statistics and Information (DEIS). Results: 64,715 discharges were included with a median age of 22 years. The pathologies with the highest number of discharges were chronic tonsil and adenoids Disease (28.4%), rhinosinusal (23.3%), head and neck neoplasms (15.2%) and ear (7.8%). Conclusion: Chronic tonsil and adenoids disease persists as the pathology with the most discharges. Neoplastic diseases and diagnoses related to improvement of quality of life emerge in importance. There are errors in the coding of diagnoses that require discussion within the specialty to improve the quality of the registry.
Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Otorrinolaringopatias/epidemiologia , Alta do Paciente/estatística & dados numéricos , Tonsila Faríngea , Distribuição de Qui-Quadrado , Chile/epidemiologia , Prevalência , Estudos TransversaisRESUMO
SARS-CoV-2 is the causative agent of COVID-19. The dimeric form of the viral Mpro is responsible for the cleavage of the viral polyprotein in 11 sites, including its own N and C-terminus. The lack of structural information for intermediary forms of Mpro is a setback for the understanding its self-maturation process. Herein, we used X-ray crystallography combined with biochemical data to characterize multiple forms of SARS-CoV-2 Mpro. For the immature form, we show that extra N-terminal residues caused conformational changes in the positioning of domain-three over the active site, hampering the dimerization and diminishing its activity. We propose that this form preludes the cis and trans-cleavage of N-terminal residues. Using fragment screening, we probe new cavities in this form which can be used to guide therapeutic development. Furthermore, we characterized a serine site-directed mutant of the Mpro bound to its endogenous N and C-terminal residues during dimeric association stage of the maturation process. We suggest this form is a transitional state during the C-terminal trans-cleavage. This data sheds light in the structural modifications of the SARS-CoV-2 main protease during its self-maturation process.
Assuntos
Peptídeo Hidrolases/química , Peptídeo Hidrolases/metabolismo , SARS-CoV-2/metabolismo , Proteínas Virais/química , Proteínas Virais/metabolismo , Domínio Catalítico/fisiologia , Cristalografia por Raios X/métodos , Dimerização , HumanosRESUMO
Resumen Objetivo: Identificar los factores determinantes de la mejoría de la calidad de vida en pacientes sometidos a cirugía de contorno corporal. Materiales y Método: Se estudió una cohorte prospectiva de 113 pacientes sometidos a cirugía de contorno corporal. Se estudiaron características sociodemográficas, mediciones antropométricas, variables relativas a la cirugía y se aplicó el instrumento Body-Qol®. Para el análisis estadístico se utilizó estadística descriptiva, modelos de ecuaciones de estimación generalizada y modelos de regresión lineal y logística. Resultados: Se encontró mejoría en la calidad de vida de forma global (p < 0,0001) y por dominios. Los pacientes con pérdida masiva de peso tuvieron peores puntajes pre y postoperatorio, sin embargo, un delta de mejoría comparable con los pacientes estéticos. Dentro de los factores determinantes, existió una relación positiva entre la edad y la mejoría en la calidad de vida de forma global. El índice de masa corporal (IMC) se encontró asociado negativamente con la mejoría del puntaje global. Dentro de los factores de la cirugía, los pacientes sometidos a lipoabdominoplastía tuvieron una mayor mejoría con respecto a otras técnicas. Además, el patrón de resección ampliado y en flor de Lis se asoció a menor mejoría en el puntaje global. Conclusión: La cirugía de contorno corporal mejora la calidad de vida de forma significativa. Los principales factores determinantes de esta mejoría fueron la edad, el IMC, el antecedente de pérdida masiva de peso y el patrón de resección.
Aim: To identify the factors that have an impact on the quality of life of patients with body contouring surgery. Materials and Method: A prospective cohort of 113 patients was studied. Sociodemographic characteristics, antropometric measures and variables related to the surgery were analized. The Body-Qol® instrument was aplied. Descriptive statistic, generalized estimated equation models and lineal and logistic regresions were used for the statistical analysis. Results: Improvement in the quality of life was found globally (p < 0,0001) and in every domain of the scale. The patients with massive weight loss had worse scores pre- and post-operatively than the esthetic patients. A positive association between age and improvement on quality of life was found. Body mass index (BMI) was negatively associated with improvement of the score. The patients that had a lipoabdominoplasty had a major improvement in comparison with other techniques. Also, the extended resection pattern and Fleur de Lis pattern were associated with lesser improvement in the global score. Conclusion: Body contouring surgery improves quality of life significantly. The principal factors that have an impact on quality of life were age, BMI, massive weight loss and resection pattern.
Assuntos
Humanos , Masculino , Feminino , Qualidade de Vida , Procedimentos de Cirurgia Plástica , Contorno Corporal , Redução de Peso , Índice de Massa Corporal , Epidemiologia Descritiva , Estudos ProspectivosRESUMO
Helicoverpa armigera (Hübner) (Lepidoptera: Noctuidae) is an important pest capable of colonizing several species of cultivated plants, including soybean [Glycine max (L.) Merrill]. The primary management strategy for this insect is chemical control and adoption of Bt plants. However, alternative environmentally friendly strategies should be investigated and adopted as available for sustainable management of this insect pest. One potential underutilized method for insect control is plant resistance. The objective of this study was to categorize resistance (antixenosis and antibiosis) of 22 soybean genotypes on H. armigera in a laboratory setting. A preliminary experiment was conducted using soybean leaves and pods to determine the most promising genotypes for resistance. For each selected genotype, we collected biological parameters, leaf intake, and performed confinement tests. The genotypes PI 227687, PI 274453, PI 274454, PI 229358, PI 171451, 'IAC 17', and 'IAC 19' expressed resistance against H. armigera. Each genotype lowered larval survivorship. The genotypes PI 229358, PI 227687, PI 274453, and PI 274454 expressed resistance by prolonging larval development and reducing fifth-instar larvae weight. 'IAC 19' reduced leaf consumption and lowered the weight of fifth-instar larvae. Antixenosis was found in genotypes PI 227687, PI 274454, and 'IAC 19'. These genotypes might be used in breeding programs focusing on soybean resistance to lepidopterans.
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Lepidópteros , Mariposas , Animais , Genótipo , Controle de Insetos , Larva , Glycine maxRESUMO
RESUMEN El hematoma paroxístico de los dedos hace referencia a pacientes que padecen episodios súbitos de dolor y edema en uno o más dígitos con la subsecuente aparición de un hematoma, predominantemente en la región palmar de las falanges proximales. El hematoma paroxístico de los dígitos es una condición rara y benigna de etiología desconocida. Los síntomas prodrómicos como dolor, hormigueo y picazón pueden ocurrir desde minutos hasta horas antes de que aparezca el cambio de coloración. El sangrado subdérmico por lo general se detiene espontáneamente o minutos después de aplicar presión local y los cambios de coloración usualmente desaparecen. El diagnóstico se basa estrictamente en las características clínicas ya que todas las investigaciones de rutina suelen ser normales. El curso de esta condición es benigno y los síntomas se resuelven sin dejar secuelas permanentes. Los médicos deberían encontrarse alertas sobre esta condición para reconocerla y asesorar correctamente al paciente acerca de su pronóstico y evitar el pedido de estudios complementarios innecesarios.
SUMMARY Paroxysmal finger hematoma refers to patients suffering from episodic pain and swelling in one or more digits with subsequent appearance of a hematoma in the palmar aspect of the proximal phalanges. Paroxysmal finger hematoma is a rare and benign condition of unknown etiology. Prodromal symptoms such as pain, tingling and itching may occur from minutes to hours before the color change appears. Subdermal bleeding usually stops spontaneously or after local pressure is applied, and changes in coloration usually disappear. The diagnosis is strictly based on the clinical features since all routine investigations are usually normal. The course of this condition is benign and the symptoms resolve without permanent sequelae. Doctors should become aware of this condition to advise their patients about the prognosis and to avoid the request of unnecessary additional studies.
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BACKGROUND: To propose a new surgical technique for fixing the nasal septum to the midline, for long term prevention of nasal obstruction, in secondary and select cases of primary septoplasty. METHODOLOGY: Retrospective study, within hospital medical center. PATIENTS: Two hundred and twenty two patients who underwent septoplasty. Data collection occurred consecutively between March 1st of 2000 and May 1st 2016. Twenty six percent females and seventy four percent males. MAIN OUTCOME MEASURES: Patterns of septal deformity, materials used for titanium plates, surgical results, symptom improvement, and surgical complications were investigated. RESULTS: A total of 222 patients were included in this study. 163 patients (73%) had no previous nasal surgery. Fifty nine patients (27%) presented with a previous nasal surgery. Sixteen year follow up included more than 90% of patients and resulted in an overall 2.7% revision rate. CONCLUSIONS: The use of titanium plate for septoplasty has shown to be simple, safe, and easy to learn technique in both secondary and select cases of primary septoplasty. Most importantly the results indicate a long term prevention of the.
Assuntos
Placas Ósseas , Septo Nasal/cirurgia , Deformidades Adquiridas Nasais/cirurgia , Seguimentos , Humanos , Reoperação/estatística & dados numéricos , Estudos Retrospectivos , TitânioRESUMO
Pulmonary arterial hypertension (PAH) is characterized by vasoconstriction and proliferative obstruction of pulmonary vessels, which promotes a progressive increase in pulmonary vascular resistance (PVR). The effect of exercise training on oxidative stress, metabolism, and markers of nitric oxide (NO) and endothelin-1 (ET-1) was analyzed in the lung tissue of rats with PAH induced by monocrotaline (MCT).Twenty-four Wistar rats were divided into four groups (5-7 animals): sedentary control (SC), sedentary MCT (SM), trained control (TC), and trained MCT (TM). The TC and TM groups participated in a treadmill training protocol (60% VO2 max) for 5 weeks, 3 weeks of which were performed after the injection of MCT (60 mg/kg i.p.) or saline. MCT administration promoted an increase in PVR and right ventricle hypertrophy, and reduction of right ventricle systolic function assessed by echocardiography. These changes were not improved by exercise training. The activity of NO synthase was reduced in the animals of the TC, TM, and SM groups. No significant differences were found in total nitrite concentration and expression of endothelial NO synthase. Moreover, the TM group showed strong staining for iNOS and nitrotyrosine, suggesting an increase in oxidative stress in these animals. In parallel, reduced expression of type B ET-1 receptors was noticed in the SM and TM groups in comparison to controls. In conclusion, the aerobic training protocol was unable to mitigate changes in the metabolism of NO and ET-1, probably because of the disease severity in these animals, especially in the TM group.
Assuntos
Endotelina-1/metabolismo , Hipertensão Pulmonar/metabolismo , Óxido Nítrico/metabolismo , Tecido Parenquimatoso/metabolismo , Condicionamento Físico Animal/fisiologia , Animais , Modelos Animais de Doenças , Hipertensão Pulmonar/induzido quimicamente , Hipertensão Pulmonar/fisiopatologia , Masculino , Monocrotalina/efeitos adversos , Óxido Nítrico Sintase Tipo III/metabolismo , Nitritos/metabolismo , Ratos , Ratos Wistar , Resistência Vascular/efeitos dos fármacosRESUMO
Scarcity of water in the world, virtually, has two sources: the quality and the quantity made available for populations. In the area covered by this study, the selected municipalities from the river basins 3 e 4 of the Paranapanema River and from the basin of the Pirapó River, availability is always greater than the demand and the environmental problems are more often linked to the quality than to the quantity of water. To check the socioeconomic aspects and the daily practices involving water resources and environmental problems we selected a representative sample of families from 10 studied municipalities. The main conclusions point to the existence of key municipalities, regarded as foci of pollution, i. e., the municipalities do not contribute in equal measure to the pollution of rivers from their regions and some stand out in economic activities and inherited cultural practices. However, respondents did not always relate the environmental impacts with their routine and productive activities. Thus, although the new legal environment imposes new practices, there are still cultural heritages, which require more incisive and continuous public interventions.
Resumo A escassez das águas, no mundo inteiro, praticamente, tem duas fontes: a qualidade e a quantidade disponibilizada para as populações. Na área de abrangência do presente estudo, nos municípios selecionados das bacias hidrográficas do Paranapanema 3 e 4 e o Pirapó, a disponibilidade é sempre maior que a demanda e os problemas ambientais estão ligados mais à qualidade do que a quantidade de águas. Para verificação dos aspectos socioeconômicos e das práticas cotidianas que envolvem os recursos hídricos e os problemas ambientais selecionou-se uma amostra significativa de famílias dos 10 municípios estudados. Como algumas conclusões tem-se que existem municípios-chaves focos de poluição, ou seja, os municípios não contribuem de maneira igual para a poluição dos rios de suas regiões e alguns se destacam nas atividades econômicas e incorretas práticas culturais herdadas. Contudo, os impactos ambientais nem sempre são relacionados, pelos entrevistados, com as suas atividades rotineiras e produtivas. Com isso, por um lado, verifica-se que o novo ambiente legal impõe novas práticas, contudo, por outro lado, ainda persistem as heranças culturais herdadas que, o que exige intervenções públicas mais contundentes e contínuas.
Assuntos
Meio Ambiente , Rios , Qualidade da Água , Brasil , Cidades , Fatores SocioeconômicosRESUMO
Scarcity of water in the world, virtually, has two sources: the quality and the quantity made available for populations. In the area covered by this study, the selected municipalities from the river basins 3 e 4 of the Paranapanema River and from the basin of the Pirapó River, availability is always greater than the demand and the environmental problems are more often linked to the quality than to the quantity of water. To check the socioeconomic aspects and the daily practices involving water resources and environmental problems we selected a representative sample of families from 10 studied municipalities. The main conclusions point to the existence of key municipalities, regarded as foci of pollution, i. e., the municipalities do not contribute in equal measure to the pollution of rivers from their regions and some stand out in economic activities and inherited cultural practices. However, respondents did not always relate the environmental impacts with their routine and productive activities. Thus, although the new legal environment imposes new practices, there are still cultural heritages, which require more incisive and continuous public interventions.(AU)
A escassez das águas, no mundo inteiro, praticamente, tem duas fontes: a qualidade e a quantidade disponibilizada para as populações. Na área de abrangência do presente estudo, nos municípios selecionados das bacias hidrográficas do Paranapanema 3 e 4 e o Pirapó, a disponibilidade é sempre maior que a demanda e os problemas ambientais estão ligados mais à qualidade do que a quantidade de águas. Para verificação dos aspectos socioeconômicos e das práticas cotidianas que envolvem os recursos hídricos e os problemas ambientais selecionou-se uma amostra significativa de famílias dos 10 municípios estudados. Como algumas conclusões tem-se que existem municípios-chaves focos de poluição, ou seja, os municípios não contribuem de maneira igual para a poluição dos rios de suas regiões e alguns se destacam nas atividades econômicas e incorretas práticas culturais herdadas. Contudo, os impactos ambientais nem sempre são relacionados, pelos entrevistados, com as suas atividades rotineiras e produtivas. Com isso, por um lado, verifica-se que o novo ambiente legal impõe novas práticas, contudo, por outro lado, ainda persistem as heranças culturais herdadas que, o que exige intervenções públicas mais contundentes e contínuas.(AU)
Assuntos
Bacias Hidrográficas/análise , Meio Ambiente , Meio AmbienteRESUMO
Scarcity of water in the world, virtually, has two sources: the quality and the quantity made available for populations. In the area covered by this study, the selected municipalities from the river basins 3 e 4 of the Paranapanema River and from the basin of the Pirapó River, availability is always greater than the demand and the environmental problems are more often linked to the quality than to the quantity of water. To check the socioeconomic aspects and the daily practices involving water resources and environmental problems we selected a representative sample of families from 10 studied municipalities. The main conclusions point to the existence of key municipalities, regarded as foci of pollution, i. e., the municipalities do not contribute in equal measure to the pollution of rivers from their regions and some stand out in economic activities and inherited cultural practices. However, respondents did not always relate the environmental impacts with their routine and productive activities. Thus, although the new legal environment imposes new practices, there are still cultural heritages, which require more incisive and continuous public interventions.
Resumo A escassez das águas, no mundo inteiro, praticamente, tem duas fontes: a qualidade e a quantidade disponibilizada para as populações. Na área de abrangência do presente estudo, nos municípios selecionados das bacias hidrográficas do Paranapanema 3 e 4 e o Pirapó, a disponibilidade é sempre maior que a demanda e os problemas ambientais estão ligados mais à qualidade do que a quantidade de águas. Para verificação dos aspectos socioeconômicos e das práticas cotidianas que envolvem os recursos hídricos e os problemas ambientais selecionou-se uma amostra significativa de famílias dos 10 municípios estudados. Como algumas conclusões tem-se que existem municípios-chaves focos de poluição, ou seja, os municípios não contribuem de maneira igual para a poluição dos rios de suas regiões e alguns se destacam nas atividades econômicas e incorretas práticas culturais herdadas. Contudo, os impactos ambientais nem sempre são relacionados, pelos entrevistados, com as suas atividades rotineiras e produtivas. Com isso, por um lado, verifica-se que o novo ambiente legal impõe novas práticas, contudo, por outro lado, ainda persistem as heranças culturais herdadas que, o que exige intervenções públicas mais contundentes e contínuas.
RESUMO
Scarcity of water in the world, virtually, has two sources: the quality and the quantity made available for populations. In the area covered by this study, the selected municipalities from the river basins 3 e 4 of the Paranapanema River and from the basin of the Pirapó River, availability is always greater than the demand and the environmental problems are more often linked to the quality than to the quantity of water. To check the socioeconomic aspects and the daily practices involving water resources and environmental problems we selected a representative sample of families from 10 studied municipalities. The main conclusions point to the existence of key municipalities, regarded as foci of pollution, i. e., the municipalities do not contribute in equal measure to the pollution of rivers from their regions and some stand out in economic activities and inherited cultural practices. However, respondents did not always relate the environmental impacts with their routine and productive activities. Thus, although the new legal environment imposes new practices, there are still cultural heritages, which require more incisive and continuous public interventions.
Assuntos
Meio Ambiente , Rios , Qualidade da Água , Brasil , Cidades , Fatores SocioeconômicosRESUMO
AIM: The aim of this study was to determine the incidence and prognostic factors of postoperative liver failure in patients submitted to liver resection for colorectal metastases. METHOD: Patients with CLM who underwent hepatectomy from 1998 to 2009 were included in retrospective analysis. Postoperative liver failure was defined using either the 50-50 criteria or the peak of serum bilirubin level above 7 mg/dL independently. RESULTS: Two hundred and nine (209) procedures were performed in 170 patients. 120 surgeries were preceded by chemotherapy within six months. The overall morbidity rate was 53.1% and 90-day mortality was 2.3%. Postoperative liver failure occurred in 10% of all procedures, accounting for a mortality rate of 9.5% among this group of patients. In multivariate analysis, extent of liver resection, need of blood transfusion and more than eight preoperative chemotherapy cycles were independent prognostic factors of postoperative liver insufficiency. This complication was not related with the chemotherapy regimen used. CONCLUSION: We conclude that postoperative liver failure has a relatively low incidence (10%) after CLM resection, but a remarkable impact on postoperative mortality rate. The amount of liver resected, the need of blood transfusion and extended preoperative chemotherapy are independent predictors of its occurrence and this knowledge can be used to prevent postoperative liver failure in a multidisciplinary approach.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Neoplasias Colorretais/patologia , Hepatectomia/efeitos adversos , Falência Hepática/etiologia , Neoplasias Hepáticas/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Transfusão de Sangue , Brasil/epidemiologia , Neoplasias Colorretais/tratamento farmacológico , Neoplasias Colorretais/mortalidade , Relação Dose-Resposta a Droga , Feminino , Hepatectomia/mortalidade , Humanos , Incidência , Falência Hepática/epidemiologia , Falência Hepática/mortalidade , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/mortalidade , Neoplasias Hepáticas/secundário , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Prognóstico , Estudos Retrospectivos , Fatores de RiscoRESUMO
Lipid emulsion (LE) containing medium/ω-6 long chain triglyceride-based emulsion (MCT/ω-6 LCT LE) has been recommended in the place of ω-6 LCT-based emulsion to prevent impairment of immune function. The impact of MCT/ω-6 LCT LE on lymphocyte and neutrophil death and expression of genes related to inflammation was investigated. Seven volunteers were recruited and infusion of MCT/ω-6 LCT LE was performed for 6 h. Four volunteers received saline and no change was found. Blood samples were collected before, immediately afterwards and 18 h after LE infusion. Lymphocytes and neutrophils were studied immediately after isolation and after 24 and 48 h in culture. The following determinations were carried out: plasma-free fatty acids, triacylglycerol and cholesterol concentrations, plasma fatty acid composition, neutral lipid accumulation in lymphocytes and neutrophils, signs of lymphocyte and neutrophil death and lymphocyte expression of genes related to inflammation. MCT/ω-6 LCT LE induced lymphocyte and neutrophil death. The mechanism for MCT/ω-6 LCT LE-dependent induction of leucocyte death may involve changes in neutral lipid content and modulation of expression of genes related to cell death, proteolysis, cell signalling, inflammatory response, oxidative stress and transcription.
Assuntos
Emulsões Gordurosas Intravenosas/farmacologia , Ácidos Graxos Ômega-6/farmacologia , Regulação da Expressão Gênica/efeitos dos fármacos , Inflamação/genética , Leucócitos/citologia , Leucócitos/efeitos dos fármacos , Triglicerídeos/farmacologia , Adulto , Apoptose/efeitos dos fármacos , Morte Celular/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Colesterol/sangue , Fragmentação do DNA , Ácidos Decanoicos/sangue , Regulação para Baixo/efeitos dos fármacos , Regulação para Baixo/genética , Emulsões Gordurosas Intravenosas/química , Emulsões Gordurosas Intravenosas/metabolismo , Ácidos Graxos não Esterificados/análise , Ácidos Graxos não Esterificados/sangue , Ácidos Graxos Ômega-6/sangue , Ácidos Graxos Ômega-6/química , Ácidos Graxos Ômega-6/metabolismo , Perfilação da Expressão Gênica , Regulação da Expressão Gênica/genética , Humanos , Contagem de Leucócitos , Leucócitos/metabolismo , Linfócitos/efeitos dos fármacos , Linfócitos/metabolismo , Linfócitos/patologia , Masculino , Necrose/induzido quimicamente , Necrose/patologia , Neutrófilos/efeitos dos fármacos , Neutrófilos/patologia , Ácidos Palmíticos/sangue , Ácidos Esteáricos/sangue , Substâncias Reativas com Ácido Tiobarbitúrico/metabolismo , Triglicerídeos/sangue , Triglicerídeos/química , Triglicerídeos/metabolismo , Regulação para Cima/efeitos dos fármacos , Regulação para Cima/genética , Adulto JovemRESUMO
The hematological parameters red blood cells (RBC) and total white blood cells (WBC) counts, hematocrit, hemoglobin concentration, and RBC indexes (median corpuscular volume and median corpuscular hemoglobin concentration) were determined and T CD5+ lymphocytes and CD4+ and CD8+ subpopulations of the umbilical cord blood (UCB) of dogs were quantified by the cytofluorimetric technique. Nine adult Beagles, from two do five-year old, were used as control. The umbilical cord blood (UCB) was collected from 20 neonate dogs. The method for the UCB collection was adequate to obtain sufficient quantity of blood for the accomplishment of the hematological analyses and lymphocyte quantification. Cytoscopic preparations of the UCB suggested high erythropoietic activity. There was no difference for the global leukocyte and lymphocyte counts between the groups. UCB T lymphocyte counts were lower than those obtained for adult dogs. The proportion of CD4:CD8 showed a great dominance of T CD4+ cells over T CD8+ lymphocytes in UCB.
Determinaram-se os valores hematológicos da contagem de hemácias, contagem total de leucócitos, hematócrito, concentração de hemoglobina e os índices hematimétricos (volume corpuscular médio e concentração de hemoglobina corpuscular média) e quantificaram-se os linfócitos T CD5+ e as subpopulações CD4+ e CD8+ do sangue do cordão umbilical (SCU) de cães por meio da técnica de citometria de fluxo. Nove cães adultos, da raça Beagle, foram utilizados como controle. O SCU foi colhido de 20 cães neonatos, a termo. O método de colheita de SCU utilizado proporcionou quantidade suficiente de sangue para realização das análises hematológicas e quantificação de linfócitos. As preparações citoscópicas do SCU sugeriram elevada atividade eritropoética. Não houve diferença nas contagens globais de leucócitos e linfócitos entre os grupos. A contagem de linfócitos T no SCU foi mais baixa que a obtida em animais adultos. A proporção CD4:CD8 obtida demonstrou a grande dominância das células T CD4+ sobre os linfócitos T CD8+ no SCU canino.
RESUMO
The hematological parameters red blood cells (RBC) and total white blood cells (WBC) counts, hematocrit, hemoglobin concentration, and RBC indexes (median corpuscular volume and median corpuscular hemoglobin concentration) were determined and T CD5+ lymphocytes and CD4+ and CD8+ subpopulations of the umbilical cord blood (UCB) of dogs were quantified by the cytofluorimetric technique. Nine adult Beagles, from two do five-year old, were used as control. The umbilical cord blood (UCB) was collected from 20 neonate dogs. The method for the UCB collection was adequate to obtain sufficient quantity of blood for the accomplishment of the hematological analyses and lymphocyte quantification. Cytoscopic preparations of the UCB suggested high erythropoietic activity. There was no difference for the global leukocyte and lymphocyte counts between the groups. UCB T lymphocyte counts were lower than those obtained for adult dogs. The proportion of CD4:CD8 showed a great dominance of T CD4+ cells over T CD8+ lymphocytes in UCB.(AU)
Determinaram-se os valores hematológicos da contagem de hemácias, contagem total de leucócitos, hematócrito, concentração de hemoglobina e os índices hematimétricos (volume corpuscular médio e concentração de hemoglobina corpuscular média) e quantificaram-se os linfócitos T CD5+ e as subpopulações CD4+ e CD8+ do sangue do cordão umbilical (SCU) de cães por meio da técnica de citometria de fluxo. Nove cães adultos, da raça Beagle, foram utilizados como controle. O SCU foi colhido de 20 cães neonatos, a termo. O método de colheita de SCU utilizado proporcionou quantidade suficiente de sangue para realização das análises hematológicas e quantificação de linfócitos. As preparações citoscópicas do SCU sugeriram elevada atividade eritropoética. Não houve diferença nas contagens globais de leucócitos e linfócitos entre os grupos. A contagem de linfócitos T no SCU foi mais baixa que a obtida em animais adultos. A proporção CD4:CD8 obtida demonstrou a grande dominância das células T CD4+ sobre os linfócitos T CD8+ no SCU canino.(AU)
Assuntos
Animais , Cães , Linfócitos T/fisiologia , Subpopulações de Linfócitos , Imunofenotipagem/métodos , Sangue Fetal , Citometria de Fluxo/métodos , Contagem de Células Sanguíneas/métodosRESUMO
The purpose of the present study was to identify the expression of p16INK4 in cervical cancer precursor lesions by immunohistochemistry and to correlate it with lesion grade and presence of human papillomavirus (HPV) infection. Cervical specimens from 144 women seen consecutively at the gynecology outpatient clinic of our institution from December 2003 to May 2005 were analyzed by cytopathology, histopathology, polymerase chain reaction for HPV-DNA, and p16INK4 immunostaining. Histologically normal biopsies, HPV-DNA negative by polymerase chain reaction, were used as control. HPV-DNA prevalence, including the control group, was 68.1% and the prevalence of p16INK4 expression was 55.0%. The percentage of cells stained by p16INK4 ranged from 10 to 100%, both in the group consisting of cervical intraepithelial neoplasia (CIN)1/HPV specimens and in the group of CIN2/CIN3 specimens with P value of 0.0001. p16INK4 expression was 48.3% in the CIN1/HPV group, as opposed to 94.3% in the CIN2/CIN3 group (P = 0.001), showing a statistically significant difference between the two groups. The quantitative method used here is simple and less subjective than the different semiquantitative methods described in the literature. In view of the different definitions of a p16INK4-positive case, it is almost impossible to compare the findings reported by different investigators. This study confirms the association between p16INK4 and CIN2 and CIN3 lesions. Moreover, it shows that some low grade lesions expressed high levels of this protein. This may indicate that such low grade lesions may be predisposed to progress to high grade lesions. This means that p16INK4 may be a strong marker for "neoplastic lesions" induced by HPV and not just an infection marker.
Assuntos
Carcinoma de Células Escamosas , Inibidor p16 de Quinase Dependente de Ciclina/metabolismo , DNA Viral/análise , Infecções por Papillomavirus/diagnóstico , Displasia do Colo do Útero , Biomarcadores Tumorais/metabolismo , Carcinoma de Células Escamosas/metabolismo , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/virologia , Estudos de Casos e Controles , Feminino , Humanos , Imuno-Histoquímica , Reação em Cadeia da Polimerase , Lesões Pré-Cancerosas/metabolismo , Lesões Pré-Cancerosas/patologia , Lesões Pré-Cancerosas/virologia , Estudos Retrospectivos , Índice de Gravidade de Doença , Displasia do Colo do Útero/metabolismo , Displasia do Colo do Útero/patologia , Displasia do Colo do Útero/virologiaRESUMO
The purpose of the present study was to identify the expression of p16INK4 in cervical cancer precursor lesions by immunohistochemistry and to correlate it with lesion grade and presence of human papillomavirus (HPV) infection. Cervical specimens from 144 women seen consecutively at the gynecology outpatient clinic of our institution from December 2003 to May 2005 were analyzed by cytopathology, histopathology, polymerase chain reaction for HPV-DNA, and p16INK4 immunostaining. Histologically normal biopsies, HPV-DNA negative by polymerase chain reaction, were used as control. HPV-DNA prevalence, including the control group, was 68.1 percent and the prevalence of p16INK4 expression was 55.0 percent. The percentage of cells stained by p16INK4 ranged from 10 to 100 percent, both in the group consisting of cervical intraepithelial neoplasia (CIN)1/HPV specimens and in the group of CIN2/CIN3 specimens with P value of 0.0001. p16INK4 expression was 48.3 percent in the CIN1/HPV group, as opposed to 94.3 percent in the CIN2/CIN3 group (P = 0.001), showing a statistically significant difference between the two groups. The quantitative method used here is simple and less subjective than the different semiquantitative methods described in the literature. In view of the different definitions of a p16INK4-positive case, it is almost impossible to compare the findings reported by different investigators. This study confirms the association between p16INK4 and CIN2 and CIN3 lesions. Moreover, it shows that some low grade lesions expressed high levels of this protein. This may indicate that such low grade lesions may be predisposed to progress to high grade lesions. This means that p16INK4 may be a strong marker for "neoplastic lesions" induced by HPV and not just an infection marker.