RESUMO
Objetivo: La litiasis biliar es una patología frecuente en Chile y el mundo, que suele presentarse como colecistocoledocolitiasis. Dentro de las alternativas para su manejo está el rendez-vous laparoendoscópico (RVLE), que consiste en una colecistectomía laparoscópica asociada a colangiopancreatografía endoscó-pica retrograda (ERCP). Este trabajo tiene como objetivo evaluar la implementación de esta técnica para el tratamiento de la colecistocoledocolitiasis en un hospital universitario. Materiales y Métodos: Cohorte retrospectiva de 4 años de pacientes con colecistocoledocolitiasis en quienes se realizó un RVLE. Resultados: Se incluyeron 296 pacientes, de edad promedio de 52 años, siendo un quinto mayor de 70 años, y presentando un 29,3% comorbilidades significativas. Un 65,2% fueron urgencias y un 12,2% presentó colangitis aguda. El éxito de la técnica fue de un 82,8%. Los cálculos mayores de 5 mm se asociaron al fracaso de ésta. La principal causa de fracaso fue el no paso de la guía hacia el duodeno (13,5%). La morbilidad, clínicamente significativa, fue de 9,5% y la mortalidad global a los 90 días fue de 0,68%. Discusión: El RVLE es un tratamiento eficaz para la colecistocoledocolitiasis en un tiempo quirúrgico, incluso en pacientes mayores de 70 años con comorbilidades, aunque con mayor morbilidad en colangitis aguda. La colangioresonancia magnética es útil en el diagnóstico y aporta información como el tamaño de los cálculos. El no paso de la guía es la principal causa de fracaso, pero se resuelve en la mayoría de los casos con una ERCP tradicional.
Objective: Gallstone disease is a common condition in Chile and worldwide, often manifesting as cholecystocholedocholithiasis. One of the treatment options is laparoendoscopic rendezvous (RVLE), involving laparoscopic cholecystectomy combined with endoscopic retrograde cholangiopancreatography (ERCP). This study aims to assess the effectiveness of this technique in managing cholecystocholedocholithiasis at a university hospital. Materials and Methods: A retrospective cohort study spanning four years was conducted on patients diagnosed with cholecystocholedocholithiasis who underwent RVLE. Results: The study included 296 patients, with an average age of 52 years. One-fifth of them were over 70 years old, and 29.3% had significant comorbidities. Of these cases, 65.2% were classified as emergencies, and 12.2% presented with acute cholangitis. The overall success rate of the RVLE procedure was 82.8%. Notably, the presence of gallstones larger than 5 mm was associated with a higher likelihood of procedure failure. The primary reason for failure was the inability of the guidewire to advance into the duodenum (13.5%). Clinically significant morbidity occurred in 9.5% of cases, and the overall mortality rate at 90 days was 0.68%. Discussion: RVLE is an effective treatment for cholecystocholedocholithiasis within a single surgical intervention, even in patients over 70-years-old with comorbidities. However, it is important to note that the procedure is associated with increased morbidity when performed in cases of acute cholangitis. Magnetic resonance cholangiopancreatography serves as a valuable diagnostic tool, providing insights into stone size. The most common cause of procedure failure is the inability of the guidewire to pass through, although this issue can often be resolved with a traditional ERCP.
RESUMO
The aim of this study was to investigate the immunohistochemical expression of REGγ, p53, MDM-2, Bcl-2, and Bax in oral tongue squamous cell carcinoma (OTSCC), and to correlate the findings with clinicopathological parameters. Fifty-eight OTSCC cases were selected for the study. The percentages of nuclear (REGγ, p53, and MDM-2) and cytoplasmic (Bcl-2 and Bax) staining in epithelial cells were determined and correlated with clinicopathological parameters (regional lymph node metastasis, clinical stage, clinical outcome, and histopathological grade of malignancy). Expression of REGγ was observed in all cases studied. Significantly lower percentages were observed in tumours with lymph node metastasis (P = 0.036) and in high-grade tumours (P = 0.013). No significant differences in p53, MDM-2, or Bax expression were observed according to the clinicopathological parameters. Lower percentages of Bcl-2 staining were found in high-grade OTSCC (P = 0.040) and in cases of disease-related death (P = 0.032). The expression of REGγ showed a weak positive correlation with the expression of MDM-2 (P = 0.001) and Bcl-2 (P = 0.014). The results of this study suggest that lower expression of REGγ may contribute to the progression of OTSCC. The role of REGγ in the development of OTSCC does not appear to be primarily related to the modulation of apoptosis in neoplastic cells.
Assuntos
Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Neoplasias da Língua , Apoptose , Autoantígenos , Carcinoma de Células Escamosas/patologia , Humanos , Metástase Linfática , Complexo de Endopeptidases do Proteassoma , Proteínas Proto-Oncogênicas c-bcl-2/metabolismo , Carcinoma de Células Escamosas de Cabeça e Pescoço , Neoplasias da Língua/patologia , Proteína Supressora de Tumor p53/metabolismo , Proteína X Associada a bcl-2/metabolismoRESUMO
Arboviruses have become a major public health concern in Brazil, especially after Zika virus (ZIKV) and Chikungunya virus (CHIKV) introduction, leading to massive epidemics. We conducted an investigation of arboviruses in patients with acute febrile illness for less than five days in Mato Grosso state (MT) during the period of ZIKV and CHIKV dissemination in Brazil. To achieve that, 453 human serum samples of patients suspected of Dengue (DENV), Yellow Fever (YFV), ZIKV or CHIKV collected in health units of 31 cities of MT were subjected to RT-PCR protocols for 10 flaviviruses, 5 alphaviruses and orthobunyaviruses from Simbu serogroup, nucleotide sequencing and viral isolation. Regarding flaviviruses, five (1.1%) patients were infected with DENV-1 genotype V, 22 (4.4%) with DENV-4 genotype II, 3 (0.7%) with YFV South American genotype II and five (1.1%) with ZIKV Asian genotype. The first human case of ZIKV in MT was detected in this study during August, 2015 in Tapurah. Alphaviruses were detected in 2 (0.4%) patients infected with CHIKV genotype ECSA, 1 (0.2%) with Madariaga (EEEV) lineage III and 34 (7.5%) with Mayaro (MAYV) genotype L. Four (11.4%) patients presented dual infections with DENV-1/ZIKV, DENV-1/DENV4, DENV-4/MAYV and ZIKV/MAYV. The majority - 13/34 positive for MAYV, one for Madariaga virus - are residents in Várzea Grande (VG), metropolitan region of Cuiabá, capital of MT. The first CHIKV infection in MT was detected in this study in Mirassol D'Oeste, during July, 2015. In addition, 20 (4.4%) patients were positive for OROV Segment S genotype IA. These results reinforce the variation in arboviruses frequency and distribution during outbreaks, highlinghing the importance of differential diagnosis to identify agents silently co-circulating with major health problem arboviruses.
Assuntos
Arbovírus/genética , Arbovírus/isolamento & purificação , Febre de Chikungunya/epidemiologia , Dengue/epidemiologia , Febre/virologia , Infecção por Zika virus/epidemiologia , Adolescente , Adulto , Brasil/epidemiologia , Febre de Chikungunya/virologia , Vírus Chikungunya/genética , Vírus Chikungunya/isolamento & purificação , Criança , Pré-Escolar , Coinfecção/epidemiologia , Coinfecção/virologia , Dengue/virologia , Vírus da Dengue/genética , Vírus da Dengue/isolamento & purificação , Feminino , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Febre Amarela/epidemiologia , Febre Amarela/virologia , Vírus da Febre Amarela/genética , Vírus da Febre Amarela/isolamento & purificação , Adulto Jovem , Zika virus/genética , Zika virus/isolamento & purificação , Infecção por Zika virus/virologiaAssuntos
Teste de Materiais , Resinas Compostas , Materiais Dentários , Polimerização , Resinas CompostasRESUMO
BACKGROUND: the objective of this study was to describe the frequency of cystic lesions in a Brazilian population of patients histopathologically diagnosed in the first and second decade of life. MATERIAL AND METHODS: Retrospective descriptive cross-sectional study was performed. Biopsy records were obtained from the archives of a Brazilian referral center between 1980 and 2016. RESULTS: A total of 2.114 biopsy records of pediatric patients were analyzed with oral and maxillofacial lesions. Data such as gender, age, anatomical location, and histopathological diagnosis were collected and categorized. Among all oral and maxillofacial lesions (n=2.114), were diagnosed 294 cases of odontogenic cysts (13.9%) and 16 cases of non-odontogenic cysts (0.8%). The most frequent lesions in each group were, respectively: radicular cyst (n=145) and epidermoid cyst (n=4). These lesions were most common in female (n=158), with a mean age of 14 years. For intraosseous lesions, the mandible (n=148) was the most affected anatomic site; moreover, the floor of the mouth (n=6) was most affected by cysts in soft tissues. CONCLUSIONS: Odontogenic cysts were relatively common in population studied, but non-odontogenic cysts were rare in these patients.
Assuntos
Cistos não Odontogênicos/epidemiologia , Cistos Odontogênicos/epidemiologia , Adolescente , Brasil/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Estudos Epidemiológicos , Feminino , Humanos , Lactente , Masculino , Estudos Retrospectivos , Adulto JovemAssuntos
Carcinogênese/metabolismo , Carcinoma de Células Escamosas/metabolismo , Queilite/metabolismo , Ciclo-Oxigenase 2/metabolismo , Neoplasias Labiais/metabolismo , Adulto , Carcinogênese/patologia , Carcinoma de Células Escamosas/patologia , Queilite/patologia , Feminino , Humanos , Neoplasias Labiais/patologia , Metástase Linfática , Masculino , Gradação de Tumores , Estadiamento de NeoplasiasRESUMO
The region of Volta Grande do Xingu River, in the state of Pará, presents several kinds of land use ranging from extensive cattle farming to agroforestry, and deforestation. Currently, the Belo Monte Hydroelectric Power Plant affects the region. We present a checklist of amphibians and reptiles of the region and discuss information regarding the spatial distribution of the assemblies based on results of Environmental Programmes conducted in the area. We listed 109 amphibian (Anura, Caudata, and Gymnophiona) and 150 reptile (Squamata, Testudines, and Crocodylia) species. The regional species richness is still considered underestimated, considering the taxonomic uncertainty, complexity and cryptic diversity of various species, as observed in other regions of the Amazon biome. Efforts for scientific collection and studies related to integrative taxonomy are needed to elucidate uncertainties and increase levels of knowledge of the local diversity.
Assuntos
Anfíbios/classificação , Distribuição Animal , Biodiversidade , Répteis/classificação , Animais , Brasil , RiosRESUMO
The region of Volta Grande do Xingu River, in the state of Pará, presents several kinds of land use ranging from extensive cattle farming to agroforestry, and deforestation. Currently, the Belo Monte Hydroelectric Power Plant affects the region. We present a checklist of amphibians and reptiles of the region and discuss information regarding the spatial distribution of the assemblies based on results of Environmental Programmes conducted in the area. We listed 109 amphibian (Anura, Caudata, and Gymnophiona) and 150 reptile (Squamata, Testudines, and Crocodylia) species. The regional species richness is still considered underestimated, considering the taxonomic uncertainty, complexity and cryptic diversity of various species, as observed in other regions of the Amazon biome. Efforts for scientific collection and studies related to integrative taxonomy are needed to elucidate uncertainties and increase levels of knowledge of the local diversity.
A região da Volta Grande no Rio Xingu, localizada no estado do Pará, apresenta várias frentes de exploração que vão desde a criação animal até área de cultivo, resultando no desmatamento de fragmentos florestais. Atualmente a região está sendo impactada pela implantação da Usina Hidrelétrica de Belo Monte. A partir de dados obtidos através dos Programas de Monitoramento Ambiental realizados na área de influência da UHE Belo Monte, apresentamos uma listagem das espécies de anfíbios e répteis, com comentários sobre a distribuição espacial das assembleias. Foram catalogados 109 espécies de anfíbios (Anura, Caudata e Gymnophiona) e 150 de répteis (Squamata, Testudines e Crocodylia). Considerando as incertezas taxonômicas, a complexidade e a diversidade críptica de várias espécies, a riqueza regional ainda continua subestimada, assim como observado em outras regiões da Amazônia. Esforços direcionados ao aproveitamento científico e estudos que contemplem a taxonomia integrativa são necessários para elucidar as incertezas e aumentar o nível de conhecimento sobre a diversidade da região.
Assuntos
Animais , Anfíbios/classificação , Biodiversidade , Distribuição Animal , Répteis/classificação , Brasil , RiosRESUMO
The region of Volta Grande do Xingu River, in the state of Pará, presents several kinds of land use ranging from extensive cattle farming to agroforestry, and deforestation. Currently, the Belo Monte Hydroelectric Power Plant affects the region. We present a checklist of amphibians and reptiles of the region and discuss information regarding the spatial distribution of the assemblies based on results of Environmental Programmes conducted in the area. We listed 109 amphibian (Anura, Caudata, and Gymnophiona) and 150 reptile (Squamata, Testudines, and Crocodylia) species. The regional species richness is still considered underestimated, considering the taxonomic uncertainty, complexity and cryptic diversity of various species, as observed in other regions of the Amazon biome. Efforts for scientific collection and studies related to integrative taxonomy are needed to elucidate uncertainties and increase levels of knowledge of the local diversity.(AU)
A região da Volta Grande no Rio Xingu, localizada no estado do Pará, apresenta várias frentes de exploração que vão desde a criação animal até área de cultivo, resultando no desmatamento de fragmentos florestais. Atualmente a região está sendo impactada pela implantação da Usina Hidrelétrica de Belo Monte. A partir de dados obtidos através dos Programas de Monitoramento Ambiental realizados na área de influência da UHE Belo Monte, apresentamos uma listagem das espécies de anfíbios e répteis, com comentários sobre a distribuição espacial das assembleias. Foram catalogados 109 espécies de anfíbios (Anura, Caudata e Gymnophiona) e 150 de répteis (Squamata, Testudines e Crocodylia). Considerando as incertezas taxonômicas, a complexidade e a diversidade críptica de várias espécies, a riqueza regional ainda continua subestimada, assim como observado em outras regiões da Amazônia. Esforços direcionados ao aproveitamento científico e estudos que contemplem a taxonomia integrativa são necessários para elucidar as incertezas e aumentar o nível de conhecimento sobre a diversidade da região.(AU)
Assuntos
Animais , Anfíbios/classificação , Distribuição Animal , Biodiversidade , Répteis/classificação , Brasil , RiosRESUMO
The results obtained in evaluating the efficiency of a Neuro-Fuzzy System NEFCLASS (Neuro-Fuzzy Classification) in image classification of cattle tuberculosis, based on its texture features extracted using the wavelet transform are presented. For testing, images of animal tissues diagnosed with tuberculosis were used, as provided by the Tuberculosis Laboratory at the Instituto Biológico de São Paulo. The results of this study can serve as a basis for developing systems for diagnosis aimed at reducing human effort, by automating all or parts of the classification of images, helping lab technicians to sort amongst different pathologies.
Assuntos
Animais , Bovinos , Sistemas Computacionais , Técnicas e Procedimentos Diagnósticos/veterinária , Tuberculose/patologia , Bovinos/classificação , Indústria Agropecuária/métodosRESUMO
The results obtained in evaluating the efficiency of a Neuro-Fuzzy System NEFCLASS (Neuro-Fuzzy Classification) in image classification of cattle tuberculosis, based on its texture features extracted using the wavelet transform are presented. For testing, images of animal tissues diagnosed with tuberculosis were used, as provided by the Tuberculosis Laboratory at the Instituto Biológico de São Paulo. The results of this study can serve as a basis for developing systems for diagnosis aimed at reducing human effort, by automating all or parts of the classification of images, helping lab technicians to sort amongst different pathologies.(AU)
Assuntos
Animais , Bovinos , Sistemas Computacionais , Técnicas e Procedimentos Diagnósticos/veterinária , Tuberculose/patologia , Bovinos/classificação , Indústria Agropecuária/métodosRESUMO
The aim of this work is to analize the evolution of osteotomies in goat's tibia by image processing...
Assuntos
Regeneração Óssea , Calo Ósseo , Processamento de Imagem Assistida por Computador , Ovinos , Tíbia , Fraturas da TíbiaRESUMO
American trypanosomiasis (Chagas' disease) can be transmitted by blood transfusion. For almost 40 years, this transmission has been limited to Latin America, but recently, three cases have been reported in the USA and Canada. With increasing emigration to North America and Europe, Chagas' disease may be introduced to the Northern hemisphere by transfusion of blood from carriers. This review will focus on the discovery, biology and antigenic profile of Trypanosoma cruzi (the aetiological agent of Chagas' disease), including the invertebrate vectors, animal reservoirs and transmission to humans, with special reference to blood transfusion. Finally, diagnostic tests and prophylactic measures for the prevention of Chagas' disease will be discussed.
Assuntos
Doença de Chagas/transmissão , Reação Transfusional , Animais , Antígenos de Protozoários/análise , Doença de Chagas/diagnóstico , Doença de Chagas/prevenção & controle , Interações Hospedeiro-Parasita , Humanos , América do Norte/epidemiologia , Prevalência , América do Sul/epidemiologia , Trypanosoma cruzi/imunologiaRESUMO
The prevalence of HIV-1 antibodies in selected groups of individuals from Rio de Janeiro, São Paulo and Santos was determined retrospectively. These groups and respective prevalences were: hemophiliac patients from Rio de Janeiro (1983-1984) 98.0%; polytransfused hemodialysis patients from São Paulo (1985-1986) 3.0% and (1987) 7.7%; intravenous drug addicts from São Paulo and Rio de Janeiro (1986-1987) 15.9%; male prisoners from São Paulo (1988) 12.5%, and pregnant women from Santos (1988-1989) 3.6%. These data stress the magnitude of AIDS in Brazil.
Assuntos
Soroprevalência de HIV , HIV-1 , Adolescente , Adulto , Brasil/epidemiologia , Feminino , Anticorpos Anti-HIV/análise , HIV-1/imunologia , Hemofilia A , Humanos , Masculino , Gravidez , Prisioneiros , Diálise Renal , Estudos Retrospectivos , Estudos Soroepidemiológicos , Abuso de Substâncias por Via IntravenosaRESUMO
We conducted a serologic survey for antibodies to human immunodeficiency virus types 1 and 2 (HIV-1 and HIV-2) and human T-cell lymphotropic virus Type I (HTLV-I) in 704 Brazilians with the acquired immunodeficiency syndrome (AIDS) or at risk for it. The study population included 70 homosexual men (11 of whom were prostitutes), 58 bisexual men (19 of whom were prostitutes), 101 female prostitutes from three socioeconomic groups, 13 wives of men with hemophilia who were seropositive for HIV-1 antibodies, and 47 blood donors with positive Venereal Disease Research Laboratory tests for syphilis, all from Rio de Janeiro; 86 female prostitutes from two rural towns in Minas Gerais; 133 patients with AIDS from São Paulo; and 196 men with bleeding disorders who were seropositive for HIV-1 antibodies on enzyme-linked immunosorbent assay, from São Paulo and Rio de Janeiro. The prevalence of HIV-1 infection was highest in the homosexual male prostitutes (45 percent), the wives of patients with hemophilia (38 percent), the bisexual men (28 percent), the homosexual men who were not prostitutes (19 percent), and the female prostitutes from the lower class (9 percent). Combined HIV-1 and HIV-2 infection was found in 3 percent of the patients with AIDS and in 1 percent of the homosexual men. The prevalence of HTLV-I infection ranged from 1 percent in rural female prostitutes to 13 percent in HIV-1-positive men with bleeding disorders in Rio de Janeiro. Combined HIV-1 and HTLV-I infection occurred in 1 to 11 percent of some male subgroups. We conclude that in Brazil HIV-1 infection is already well established among homosexuals, bisexuals, and lower-class female prostitutes, with bisexual men probably acting as a bridge between the heterosexual and homosexual communities, that HTLV-I infection is prevalent in groups at risk for AIDS, and that HIV-2 infection has already been introduced into the country.
Assuntos
Síndrome da Imunodeficiência Adquirida/epidemiologia , HIV-1 , HIV-2 , Infecções por HTLV-I/epidemiologia , Bissexualidade , Brasil , Feminino , HIV-1/imunologia , HIV-2/imunologia , Anticorpos Anti-HTLV-I/análise , Hemofilia A , Homossexualidade , Humanos , Masculino , Casamento , Fatores de Risco , Trabalho Sexual , Fatores SocioeconômicosRESUMO
Funcao hepatica em hemofilicos. Estudamos 35 hemofilicos graves, clinica e laboratorialmente, quanto a funcao hepatica.Os hemofilicos foram classificados em grupos de acordo com o tipo de hemofilia, idade, periodicidade de tratamento, historia previa de hepatite, esplenomegalia, hepatoesplenomegalia e presenca ou ausencia de anticorpo Australia. Pelo menos 60% dos hemofilicos mostraram alguma alteracao nos parametros laboratoriais estudados (enzimas: alanina aminotransferase, aspartato aminotransferase, fosfatase alcalina, gama-glutamiltransferase, desidrogenase latica e desidrogenase isocitrica, bilirrubina proteinas totais e fracoes e imunoglobulinas e quase 90% eram portadores do anticorpo Australia. A tentativa e grau de lesao hepatica com algum grupo em especial mostrou que somente o grupo com historia previa de hepatite clinica apresentava maior frequencia de alteracoes que a encontrada globalmente nos 35 hemofilicos estudados
Assuntos
Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Humanos , Masculino , Hemofilia A , Testes de Função HepáticaRESUMO
Foram estudados 16 hemofilicos graves (12 do tipo A, 4 do tipo B) clinica e laboratorialmente. A funcao imunologica humoral foi avaliada pelos seguintes exames: proteinas, imunoglobulinas, C3, C4, ativador de C3, iso-hemaglutininas, hetero-hemaglutininas, PCR, antiestreptolisina O, latex fator reumatoide, reacao de Waaler-Rose, aglutininas para Salmonella thyphi, anticorpos para Toxoplasma gondii e Trypanosoma cruzi e anticorpo Australia (HBs Ac).A funcao celular foi avaliada pelos seguintes exames: hemograma, contagem de linfocitos, de linfocitos T circulantes (rosetas precoces e tardias) e intradermorreacoes a antigenos de memoria. As alteracoes encontradas (aumento da fracao gama e elevacao das imunoglobulinas) podem ser relacionadas com o disturbio hepatico cronico que alguns dos hemofilicos apresentam