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1.
Mar Drugs ; 20(11)2022 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-36354999

RESUMO

Acute and chronic dermatological injuries need rapid tissue repair due to the susceptibility to infections. To effectively promote cutaneous wound recovery, it is essential to develop safe, low-cost, and affordable regenerative tools. Therefore, we aimed to identify the biological mechanisms involved in the wound healing properties of the glycosaminoglycan dermatan sulfate (DS), obtained from ascidian Styela plicata, a marine invertebrate, which in preliminary work from our group showed no toxicity and promoted a remarkable fibroblast proliferation and migration. In this study, 2,4-DS (50 µg/mL)-treated and control groups had the relative gene expression of 84 genes participating in the healing pathway evaluated. The results showed that 57% of the genes were overexpressed during treatment, 16% were underexpressed, and 9.52% were not detected. In silico analysis of metabolic interactions exhibited overexpression of genes related to: extracellular matrix organization, hemostasis, secretion of inflammatory mediators, and regulation of insulin-like growth factor transport and uptake. Furthermore, in C57BL/6 mice subjected to experimental wounds treated with 0.25% 2,4-DS, the histological parameters demonstrated a great capacity for vascular recovery. Additionally, this study confirmed that DS is a potent inducer of wound-healing cellular pathways and a promoter of neovascularization, being a natural ally in the tissue regeneration strategy.


Assuntos
Dermatan Sulfato , Urocordados , Animais , Camundongos , Dermatan Sulfato/metabolismo , Dermatan Sulfato/farmacologia , Camundongos Endogâmicos C57BL , Urocordados/metabolismo , Cicatrização , Recursos Naturais
2.
Am J Clin Exp Urol ; 10(3): 129-141, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35874286

RESUMO

OBJECTIVES: Thrombosis is a major cause of early allograft loss in renal transplantation. Herein, we assessed the frequency of acute graft thrombosis in patients who underwent renal transplant and received anticoagulant or antiplatelet agents. METHODS: We performed a systematic review of all available case series studies of anticoagulant and/or antiplatelet prophylaxis of thrombosis in renal transplantation. The data were pooled in a proportional meta-analysis. RESULTS: Twenty-one case series were identified from 7,160 retrieved titles. A total of 3,246 patients were analyzed (1,718 treated with antiplatelet and/or anticoagulant agents and 1,528 non-treated control subjects). Allograft thrombosis occurred in 7.24% (95% CI 3.45 to 12.27%) of the patients receiving no intervention compared with 3.38% (95% CI 1.45 to 6.1%), 1.2% (95% CI 0.6 to 2.1%) and 0.47% (95% CI 0.001 to 1.79%) of the patients in the anticoagulant, aspirin, and aspirin + anticoagulant groups, respectively. The bleeding complication rate for anticoagulants was significantly higher than in the other groups. CONCLUSIONS: Our data suggests that anticoagulants, and aspirin, either alone or in association with an anticoagulant, seem to have a low frequency of acute allograft thrombosis after kidney transplantation. Higher hemorrhagic complication rates might occur when anticoagulants are used.

3.
Am J Clin Exp Urol ; 10(3): 188-193, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35874289

RESUMO

PURPOSE: To evaluate the correlation between the pH readings in 24-h urine and the random fasting specimen in patients with urolithiasis using 2 methods. METHODS: A total of 114 patients with urinary lithiasis using potassium citrate were prospectively analyzed. All patients collected 24-h urine and an additional sample, after nocturnal fasting, collected on the day they brought the 24-h sample at the lab. Two different methods (test strip and digital meter) were used to determine pH values. RESULTS: The pH analysis using strips in the 24-h urine presented a mean value similar to the one obtained in the fasting sample (6.07 ± 0.74 vs. 6.02 ± 0.82, respectively; P > 0.05). The same behavior was seen considering the readings with a digital pH meter (5.8 ± 0.78 vs. 5.75 ± 0.83; P > 0.05). However, readings conducted in the same specimen with pH meter and test strip were dissonant (P < 0.05), suggesting that the colorimetric method is not reliable in the assessment of urinary pH in this population. CONCLUSION: pH assessment in a random urinary specimen proved as efficient as the 24-h urine standard method to monitor patients with kidney stones in the use of potassium citrate. Classical test strip analysis is not sensitive enough to evaluate the urine pH in this population and digital pH meter reading is preferred.

4.
Investig Clin Urol ; 62(1): 79-84, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33258326

RESUMO

PURPOSE: Sexual performance is related to proprioception and pelvic floor muscle strength (PFMS). The aim of this study was to correlate sexual activity and orgasm with PFMS. MATERIALS AND METHODS: A total of 140 healthy continent female were prospectively distributed into 4 groups according to age: Group 1 (G1), 30-40; Group 2 (G2), 41-50; Group 3 (G3), 51-60; Group 4 (G4), over 60 years old. Evaluated parameters were: frequency of sexual activity and orgasm achievement; body mass index (BMI) and objective evaluation of PFMS using perineometer and surface electromyography. RESULTS: BMI was higher in G4 compared to G1 (p=0.042). Women who reported sexual activity was significantly higher in G1 compared to G3 and G4 (94.1% vs. 66.7% and 37.5%, respectively; p=0.001). Orgasm was more frequently in G1 compared to G3 and G4 (91.2% vs. 63.9% and 28.1%, respectively; p=0.001), demonstrating that sexual activity and orgasm decrease after age 51. The duration of PFM contraction was significantly higher in women who had sexual intercourse (p=0.033) and orgasm (p=0.018). CONCLUSIONS: Although the frequency of sexual intercourse and orgasm may decrease with aging, a relationship between sexual activity and PFMS remains apparent, once both sexually active women and those who have orgasms showed better PFM endurance than non-sexually active ones.


Assuntos
Força Muscular , Orgasmo , Diafragma da Pelve/fisiologia , Comportamento Sexual/fisiologia , Adulto , Fatores Etários , Idoso , Índice de Massa Corporal , Coito/fisiologia , Eletromiografia , Feminino , Humanos , Pessoa de Meia-Idade , Contração Muscular , Estudos Prospectivos
5.
Acta Cir Bras ; 34(9): e201900901, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31800678

RESUMO

PURPOSE: To evaluate the effects of tadalafil (TD) in preventing histological alterations of the corpus cavernosum caused by isolated lesions of cavernous nerve (ILCN) and artery (ILCA) in rats. METHODS: Fifty male Wistar rats were randomly assigned in five groups: G1: control; G2: bilateral ILCN; G3: bilateral ILCA; G4: ILCN+TD; G5: ILCA+TD. The cavernous bodies were submitted to histomorphometry, immunohistochemistry and biochemical analysis. RESULTS: Nerve density was significantly higher in G2 and G4 compared to control (22.62±2.84 and 19.53±3.47 vs. 15.72±1.82; respectively, p<0.05). Smooth muscle density was significantly lower in G2 and G3 in comparison to G1 (12.87±1.90 and 18.93±1.51 vs. 21.78±1.81, respectively; p<0.05). A significant decrease in the sinusoidal lumen area was observed in G2 compared to controls (5.01±1.62 vs. 9.88±3.66, respectively; p<0.05) and the blood vessel density was increased in G2 and G3 (29.32±4.13 e 20.80±2.47 vs. 10.13±2.71, p<0.05). Collagen density was higher in G3 compared to G1 (93.76±15.81 vs. 64.59±19.25; p<0.05). CONCLUSIONS: Histomorphometric alterations caused by ILCN were more intense than those produced by vascular injury, but the collagen analyses showed more fibrosis in animals with ILCA. TD was effective in preventing the majority of the alterations induced by the periprostatic bundle injury.


Assuntos
Pênis/irrigação sanguínea , Pênis/inervação , Traumatismos dos Nervos Periféricos/prevenção & controle , Inibidores da Fosfodiesterase 5/farmacologia , Substâncias Protetoras/farmacologia , Tadalafila/farmacologia , Animais , Colágeno/análise , Colágeno/efeitos dos fármacos , Tecido Elástico/anatomia & histologia , Tecido Elástico/efeitos dos fármacos , Disfunção Erétil/prevenção & controle , Imuno-Histoquímica , Masculino , Pênis/efeitos dos fármacos , Pênis/patologia , Prostatectomia/efeitos adversos , Distribuição Aleatória , Ratos Wistar , Reprodutibilidade dos Testes
6.
Psicol. conoc. Soc ; 9(2): 25-46, dic. 2019. tab
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1091832

RESUMO

Resumen: Se presentan algunos resultados de una investigación más amplia, dirigida a conocer los discursos de la infancia y su cuidado de un dispositivo de intervención de la infancia temprana en Chile. Utilizando el recurso del análisis de repertorios interpretativos (Potter y Wetherell, 1987; Wetherell y Potter 1996) se analizó un corpus textual conformado por 12 documentos institucionales. De los múltiples repertorios identificados, aquí presentamos aquellos que nos permitieron captar de forma singular las relaciones entre neurociencias, política pública e infancia: el cerebro como actor social; el riesgo como alteración; y la intervención como optimización. Concluimos, que estos repertorios colaboran a la conformación de representaciones de la infancia altamente biologizadas y fuertemente vinculadas a modelos de capital humano y representaciones tradicionales del género y la maternidad. Si bien los hallazgos de la neurociencia se plantean como promesa para superar la desigualdad social, se trataría más bien de un optimismo cruel (Edwards, Gillies y Horsley, 2015) que ocultaría las profundas desigualdades de género y sociales en nuestro país y el posicionamiento de las madres pobres como responsables de los riesgos, así como del desarrollo cerebral de sus hijos.


Abstract: Some results of a broader investigation are presented, aimed at knowing the speeches of childhood and their care of an intervention device of early childhood in Chile. Using the resource of interpretive repertoire analysis (Potter and Wetherell, 1987, Wetherell and Potter, 1996), a textual corpus consisting of 12 institutional documents was analyzed. From the multiple repertories identified, we present those that allow us to capture in a singular way the relationships between neurosciences, public policy and childhood: the brain as a social actor; the risk as alteration; and the intervention as optimization. We conclude that these repertoires collaborate in the conformation of representations of childhood that are highly biologized and strongly linked to models of human capital and traditional representations of gender and motherhood. Although the findings of neuroscience are seen as a promise to overcome social inequality, it would be rather a cruel optimism (Edwards et al., 2015) that would hide the deep gender and social inequalities in our country and the positioning of poor mothers as responsible for the risks, as well as the brain development of their children.


Resumo: São apresentados alguns resultados de uma investigação mais ampla, dirigida a conhecer os discursos da infância e seu cuidado de um dispositivo de intervencao da primeira infancia temprana no Chile. Utilizando o análise de recursos de repertórios interpretativos (Potter e Wetherer, 1987) analisou-se se um corpus textual composto de 12 documentos institucionais. Dos vários repertórios identificados, apresentamos aqueles que nos permitem captar de forma singular as relações entre neurociências, políticas públicas e infancia: o cérebro como ator social; o risco como alteração; e a intervenção como otimização. Concluímos que esses repertórios colaboram com as representações da infância altamente biologizadas e fortemente ligadas aos modelos de capital humano e representações tradicionais do gênero e maternidade. Enquanto as descobertas da neurociência surgem como uma promessa para superar a desigualdade social, mais bem tratar-se-ia de um cruel otimismo (Edwards et al., 2015) que ocultaría as profundas desigualdades de gênero e sociais em nosso país, e o posicionamento das mães pobres como responsáveis pelos riscos, bem como o desenvolvimento cerebral de seus filhos.

7.
Acta cir. bras. ; 34(9): e201900901, Nov. 2019. tab
Artigo em Inglês | VETINDEX | ID: vti-23999

RESUMO

Purpose:To evaluate the effects of tadalafil (TD) in preventing histological alterations of the corpus cavernosum caused by isolated lesions of cavernous nerve (ILCN) and artery (ILCA) in rats.Methods:Fifty male Wistar rats were randomly assigned in five groups: G1: control; G2: bilateral ILCN; G3: bilateral ILCA; G4: ILCN+TD; G5: ILCA+TD. The cavernous bodies were submitted to histomorphometry, immunohistochemistry and biochemical analysis.Results:Nerve density was significantly higher in G2 and G4 compared to control (22.62±2.84 and 19.53±3.47 vs. 15.72±1.82; respectively, p<0.05). Smooth muscle density was significantly lower in G2 and G3 in comparison to G1 (12.87±1.90 and 18.93±1.51 vs. 21.78±1.81, respectively; p<0.05). A significant decrease in the sinusoidal lumen area was observed in G2 compared to controls (5.01±1.62 vs. 9.88±3.66, respectively; p<0.05) and the blood vessel density was increased in G2 and G3 (29.32±4.13 e 20.80±2.47 vs. 10.13±2.71, p<0.05). Collagen density was higher in G3 compared to G1 (93.76±15.81 vs. 64.59±19.25; p<0.05).Conclusions:Histomorphometric alterations caused by ILCN were more intense than those produced by vascular injury, but the collagen analyses showed more fibrosis in animals with ILCA. TD was effective in preventing the majority of the alterations induced by the periprostatic bundle injury.(AU)


Assuntos
Animais , Masculino , Ratos , Tadalafila/administração & dosagem , Tadalafila/uso terapêutico , Pênis/lesões , Disfunção Erétil/prevenção & controle , Elastina , Colágeno
8.
Int J Urol ; 26(1): 57-61, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30253440

RESUMO

OBJECTIVES: To assess the correlation between hormonal status and pelvic floor muscle strength. METHODS: A total of 140 continent women were prospectively evaluated, and divided into four groups according to age: group 1 (n = 34) aged 30-40 years; group 2 (n = 38) aged 41-50 years; group 3 (n = 35) aged 51-60; and group 4 (n = 33) aged >60 years. The following parameters were evaluated: demographic data using clinical questionnaire; hypermobility of the bladder neck using swab test; vaginal trophism by gynecological examination; hormonal status of the vagina by cytology; and pelvic floor muscle strength using a perineometer and electromyography. RESULTS: There were no statistical differences between pelvic floor muscle strength, demographic characteristics, vaginal trophism and hypermobility of the bladder neck between groups (P > 0.05). There was a larger number of women with vaginal atrophy among those aged >60 years. Vaginal trophism assessed by pelvic examination was highly consistent with the findings of colpocytology (kappa test = 0.888). Electromyography showed that women with hypermobility had lower muscle resistance (endurance) when compared with those without hypermobility. CONCLUSIONS: Although vaginal atrophy is more intense in women aged >60 years, no difference can be found in the pelvic floor muscle strength during the physiological aging process in continent women. As a consequence, trophism is not the only factor related to pelvic floor muscle strength, and it should not preclude the selection of patients who are referred to prophylaxis.


Assuntos
Força Muscular/fisiologia , Diafragma da Pelve/fisiologia , Incontinência Urinária/fisiopatologia , Vagina/patologia , Adulto , Idoso , Atrofia , Eletromiografia , Feminino , Humanos , Pessoa de Meia-Idade , Urodinâmica
9.
Acta cir. bras ; Acta cir. bras;34(9): e201900901, 2019. tab
Artigo em Inglês | LILACS | ID: biblio-1054695

RESUMO

Abstract Purpose: To evaluate the effects of tadalafil (TD) in preventing histological alterations of the corpus cavernosum caused by isolated lesions of cavernous nerve (ILCN) and artery (ILCA) in rats. Methods: Fifty male Wistar rats were randomly assigned in five groups: G1: control; G2: bilateral ILCN; G3: bilateral ILCA; G4: ILCN+TD; G5: ILCA+TD. The cavernous bodies were submitted to histomorphometry, immunohistochemistry and biochemical analysis. Results: Nerve density was significantly higher in G2 and G4 compared to control (22.62±2.84 and 19.53±3.47 vs. 15.72±1.82; respectively, p<0.05). Smooth muscle density was significantly lower in G2 and G3 in comparison to G1 (12.87±1.90 and 18.93±1.51 vs. 21.78±1.81, respectively; p<0.05). A significant decrease in the sinusoidal lumen area was observed in G2 compared to controls (5.01±1.62 vs. 9.88±3.66, respectively; p<0.05) and the blood vessel density was increased in G2 and G3 (29.32±4.13 e 20.80±2.47 vs. 10.13±2.71, p<0.05). Collagen density was higher in G3 compared to G1 (93.76±15.81 vs. 64.59±19.25; p<0.05). Conclusions: Histomorphometric alterations caused by ILCN were more intense than those produced by vascular injury, but the collagen analyses showed more fibrosis in animals with ILCA. TD was effective in preventing the majority of the alterations induced by the periprostatic bundle injury.


Assuntos
Animais , Masculino , Pênis/inervação , Pênis/irrigação sanguínea , Substâncias Protetoras/farmacologia , Inibidores da Fosfodiesterase 5/farmacologia , Traumatismos dos Nervos Periféricos/prevenção & controle , Tadalafila/farmacologia , Pênis/efeitos dos fármacos , Pênis/patologia , Prostatectomia/efeitos adversos , Imuno-Histoquímica , Distribuição Aleatória , Reprodutibilidade dos Testes , Colágeno/análise , Colágeno/efeitos dos fármacos , Ratos Wistar , Tecido Elástico/anatomia & histologia , Tecido Elástico/efeitos dos fármacos , Disfunção Erétil/prevenção & controle
10.
REVISA (Online) ; 8(2): 119-131, 2019.
Artigo em Inglês, Português | LILACS | ID: biblio-1095670

RESUMO

Objetivo: identificar quais são os mecanismos de trauma e os tipos de lesões mais frequentes nos pacientes de 30 a 49 anos atendidos na sala amarela do centro de trauma de um hospital público do Distrito Federal. Método: estudo epidemiológico descritivo transversal sobre o perfil, epidemiológico e clínico. Os critérios de inclusão foram: admissões primárias, faixa-etárias 30 a 49 anos, ambos os sexos e vítima trauma, totalizando amostra com 697 admissões. Resultados: foi evidenciado que nesta faixa etária, prevaleceram os motociclistas traumatizados com 27,7%( n= 193), seguido de ocupante de automóvel traumatizado com 17,5%( n= 122) e queda da própria altura com 11,04%( n=77). Conclusão: o trabalho evidencia a necessidade das equipes componentes dos sistemas hospitalares e demais unidades que atuam diretamente ou indiretamente, com pacientes traumáticos, a necessidade de se aperfeiçoarem, na tentativa de se conhecer melhor o perfil de pacientes que buscam tratamentos nesta unidade, além de poder proporcionar uma assistência de melhor qualidade.


Objective: to identify the mechanisms of trauma and the most frequent types of injuries in patients aged 30 to 49 attended of the Federal District Public Hospital trauma center, specifically in the yellow room. Method: This is a cross-sectional descriptive epidemiological study on the epidemiological and clinical profile. ). Inclusion criteria were: primary admissions, age range 30 to 49 years, both sexes and trauma victim. The sample was composed for 697 admissions. Results: Among the injuries, it was evidenced that in this age bracket, traumatic motorcyclists prevailed with 27.7% (n = 193), followed by a traumatic motor vehicle occupant with 17.5% (n = 122) and fall of the height itself with 11.04 % (n = 77). Conclusion: This work evidences the need of the hospital system components teams and other units that act directly or indirectly, with trauma patients, the need to improve themselves, in an attempt to better understand the profile of patients who seek treatment in these units, besides being able to provide assistance.


Assuntos
Adulto Jovem
12.
Front Microbiol ; 9: 269, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29559958

RESUMO

Chagas cardiomyopathy is the most severe clinical manifestation of chronic Chagas disease. The disease affects most of the Latin American countries, being considered one of the leading causes of morbidity and death in the continent. The pathogenesis of Chagas cardiomyopathy is very complex, with mechanisms involving parasite-dependent cytopathy, immune-mediated myocardial damage and neurogenic disturbances. These pathological changes eventually result in cardiac myocyte hypertrophy, arrhythmias, congestive heart failure and stroke during chronic infection phase. Herein, we show that miR-208a, a microRNA that is a key factor in promoting cardiovascular dysfunction during cardiac hypertrophy processes of heart failure, has its circulating levels increased during chronic indeterminate phase when compared to cardiac (CARD) clinical forms in patients with Chagas disease. In contrast, we have not found altered serum levels of miR-34a, a microRNA known to promote pro-apoptotic role in myocardial infarction during degenerative process of cardiac injuries thus indicating intrinsic differences in the nature of the mechanisms underlying the heart failure triggered by Trypanosoma cruzi infection. Our findings support that the chronic indeterminate phase is a progressive phase involved in the genesis of chagasic cardiopathy and point out the use of plasma levels of miR-208a as candidate biomarker in risk-prediction score for the clinical prognosis of Chagas disease.

13.
Int. braz. j. urol ; 43(6): 1129-1135, Nov.-Dec. 2017. tab
Artigo em Inglês | LILACS | ID: biblio-892915

RESUMO

ABSTRACT Objective: To evaluate the overactive bladder (OAB) diagnosis using OAB-V8 and ICIQOAB questionnaires in women with different schooling and cultural levels. Materials and Methods: Three hundred and eighty six healthy women answered a clinical questionnaire filling out information about schooling, demographic and gynecological data. The OAB-V8 and ICIQ-OAB questionnaires were used to evaluate OAB diagnosis and symptoms; and the QS-F questionnaire, to determine the sexual function. All questionnaires were validated in Portuguese. Results: The mean age was 37.3 years-old. Regarding to schooling level, 23.1% had concluded primary education; 65.8%, secondary school; and 11.1% had higher education. Considering the OAB-V8 (score ≥8), 51.8% of evaluated women had OAB diagnosis. There was a positive linear correlation between the OAB-V8 and ICIQ-OAB questionnaires in its sections "a" (r=0.812, p<0.001) and "b" (r=759, p<0.001). There was a positive linear correlation between age and the amount of time used to answer the OAB-V8, ICIQ-OAB and QS-F questionnaires (p<0.001). The ICIQ-OAB was the hardest to answer for all schooling levels when compared to the other questionnaires. Women who had concluded primary and secondary education significantly demanded more help to answer all questionnaires than those with higher education (p<0.05). Furthermore, women with higher education took significantly less time answering all questionnaires when compared to their less educated counterparts (primary and secondary schooling), since they were quicker to answer each individual question. Conclusion: Educational level and ageing had an impact on women response using different questionnaires for OAB and sexual function evaluations.


Assuntos
Humanos , Feminino , Adulto , Classe Social , Escolaridade , Bexiga Urinária Hiperativa/diagnóstico , Inquéritos e Questionários
14.
Int Braz J Urol ; 43(6): 1129-1135, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28727389

RESUMO

OBJECTIVE: To evaluate the overactive bladder (OAB) diagnosis using OAB-V8 and ICIQ-OAB questionnaires in women with different schooling and cultural levels. MATERIALS AND METHODS: Three hundred and eighty six healthy women answered a clinical questionnaire filling out information about schooling, demographic and gynecological data. The OAB-V8 and ICIQ-OAB questionnaires were used to evaluate OAB diagnosis and symptoms; and the QS-F questionnaire, to determine the sexual function. All questionnaires were validated in Portuguese. RESULTS: The mean age was 37.3 years-old. Regarding to schooling level, 23.1% had concluded primary education; 65.8%, secondary school; and 11.1% had higher education. Considering the OAB-V8 (score ≥8), 51.8% of evaluated women had OAB diagnosis. There was a positive linear correlation between the OAB-V8 and ICIQ-OAB questionnaires in its sections "a" (r=0.812, p<0.001) and "b" (r=759, p<0.001). There was a positive linear correlation between age and the amount of time used to answer the OAB-V8, ICIQ-OAB and QS-F questionnaires (p<0.001). The ICIQ-OAB was the hardest to answer for all schooling levels when compared to the other questionnaires. Women who had concluded primary and secondary education significantly demanded more help to answer all questionnaires than those with higher education (p<0.05). Furthermore, women with higher education took significantly less time answering all questionnaires when compared to their less educated counterparts (primary and secondary schooling), since they were quicker to answer each individual question. CONCLUSION: Educational level and ageing had an impact on women response using different questionnaires for OAB and sexual function evaluations.


Assuntos
Escolaridade , Classe Social , Bexiga Urinária Hiperativa/diagnóstico , Adulto , Feminino , Humanos , Inquéritos e Questionários
15.
Bol. Hosp. Viña del Mar ; 73(2): 46-51, 2017.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1398322

RESUMO

Introducción: En pacientes VIH (+) se han descrito marcadores predictores de enfermedades asociadas a etapa SIDA, sin embargo no existe claridad respecto factores asociados enfermedades no SIDA. Una relación CD4/CD8 baja se ha identificado como marcador de inmunosenescencia y aumento de morbimortalidad en la población general, sin embargo aún está en estudio su utilidad en pacientes VIH (+). Objetivo: Determinar si una relación CD4/CD8 baja se asocia a mayor morbilidad no relacionada a etapa SIDA en pacientes VIH (+). Material y métodos: Estudio observacional de cohorte retrospectivo. Se seleccionaron pacientes VIH (+) que ingresaron un programa de vacunación contra VHB del Hospital Dr. Gustavo Fricke desde octubre de 2012. Se dividieron en grupos con relación CD4/CD8 < 0.6 y CD4/CD8 > 0.6 y se analizó la aparición de enfermedades no relacionadas a etapa SIDA en ambos grupos durante su seguimiento hasta mayo de 2016. Resultados: En la muestra de 79 pacientes, 54 (68%) tuvieron una relación CD4/CD8 < 0.6 y 25 (32%) tuvieron un CD4/CD8 > 0.6. La incidencia de enfermedades no relacionadas a etapa SIDA fue 39 (72%) pacientes en el grupo con relación CD4/CD8 baja y 13 (52%) en el grupo con relación CD4/CD8 alto (p=0.06). En 15 (19%) pacientes la relación CD4/CD8 disminuyó, esto se asoció a educación hasta enseñanza básica (p=0.01), viraje a carga viral detectable (p<0.01) y enfermedad hepática (p=0.02) Conclusión: La relación CD4/CD8 es un marcador emergente y prometedor, pero aún falta evidencia para determinar su utilidad.


Introduction: Although biomarkers predicting AIDS-associated pathology have been described, there is little clarity with respect to the markers for non AIDS-associated pathology. A low CD4/CD8 ratio has been seen to be a marker of immunesenescence and raised morbi-mortality in the general population, however its usefulness in HIV (+) patients is still being studied. Objective: To determine whether a low CD4/CD8 ratio is associated with increased AIDS-unrelated morbidity in the AIDS stage of HIV (+) patients. Materials and Methods: Observational study with retrospective cohort. HIV (+) patients were selected from patients admitted to a HBV vaccination program in Dr. Gustavo Fricke Hospital from October 2012 on. They were divided into two groups: CD4/CD8 < 0.6 and CD4/CD8 > 0.6 and followed until May 2016, analyzing the appearance of AIDS-unrelated illnesses in both groups. Results: In the 79 patient sample, 54 (68%) had CD4/CD8 ratio < 0.6 and 25 (32%) had a CD4/CD8 ratio > 0.6. The incidence of non AIDS-related illnesses in the AIDS stage was 39 (72%) in patients with a low CD4/CD8 ratio and 13 (52%) in the group with a high CD4/CD8 ratio (p=0.06). Conclusion: The CD4/CD8 ratio fell in 15 (19%) of patients, this being associated with primary education only, (p=0.01), virologic rebound (p<0.01) and liver disease.

16.
Int Braz J Urol ; 41(1): 168-71, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25928523

RESUMO

OBJECTIVE: To describe the surgical technique and initial experience with a single-port retroperitoneal renal biopsy (SPRRB). MATERIALS AND METHODS: Between January and April 2013, five children underwent SPRRB in our hospital. A single 1.5 cm incision was performed under the 12th rib at mid-axillary line, and an 11 mm trocar was inserted. A nephroscope was used to identify the kidney and dissect the perirenal fat. After lower pole exposure, a laparoscopic biopsy forceps was introduced through the nephroscope working channel to collect a renal tissue sample. RESULTS: SPRRB was successfully performed in five children. The mean operative time was 32 minutes, and mean estimated blood loss was less than 10 mL. The hospital stay of all patients was two days because they were discharged in the second postoperative day, after remaining at strict bed rest for 24 hours after the procedure. The average number of glomeruli present in the specimen was 31. CONCLUSION: SPRRB is a simple, safe and reliable alternative to open and videolaparoscopic approaches to surgical renal biopsy.


Assuntos
Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico/instrumentação , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico/métodos , Rim/patologia , Laparoscopia/métodos , Espaço Retroperitoneal/cirurgia , Perda Sanguínea Cirúrgica/prevenção & controle , Criança , Feminino , Humanos , Tempo de Internação , Masculino , Duração da Cirurgia , Reprodutibilidade dos Testes , Fatores de Tempo
17.
BMC Urol ; 15: 29, 2015 Apr 10.
Artigo em Inglês | MEDLINE | ID: mdl-25888237

RESUMO

BACKGROUND: The aim of this study was to compare pelvic floor muscle (PFM) strength using transvaginal digital palpation in healthy continent women in different age groups, and to compare the inter- and intra-rater reliability of examiners performing anterior and posterior vaginal assessments. METHODS: We prospectively studied 150 healthy multiparous women. They were distributed into four different groups, according to age range: G1 (n = 37), 30-40 years-old; G2 (n = 39), 41-50 years-old; G3 (n = 39), 51-60 years-old; and G4 (n = 35), older than 60 years-old. PFM strength was evaluated using transvaginal digital palpation in the anterior and posterior areas, by 3 different examiners, and graded using a 5-point Amaro's scale. RESULTS: There was no statistical difference among the different age ranges, for each grade of PFM strength. There was good intra-rater concordance between anterior and posterior PFM assessment, being 64.7%, 63.3%, and 66.7% for examiners A, B, and C, respectively. The intra-rater concordance level was good for each examiner. However, the inter-rater reliability for two examiners varied from moderate to good. CONCLUSIONS: Age has no effect on PFM strength profiles, in multiparous continent women. There is good concordance between anterior and posterior vaginal PFM strength assessments, but only moderate to good inter-rater reliability of the measurements between two examiners.


Assuntos
Força Muscular , Diafragma da Pelve/fisiologia , Adulto , Idoso , Índice de Massa Corporal , Feminino , Número de Gestações , Humanos , Pessoa de Meia-Idade , Palpação , Paridade , Exame Físico , Estudos Prospectivos , Reprodutibilidade dos Testes , Incontinência Urinária/fisiopatologia
18.
Int. braz. j. urol ; 41(1): 168-171, jan-feb/2015. tab, graf
Artigo em Inglês | LILACS | ID: lil-742859

RESUMO

Objective To describe the surgical technique and initial experience with a single-port retroperitoneal renal biopsy (SPRRB). Materials and Methods Between January and April 2013, five children underwent SPRRB in our hospital. A single 1.5 cm incision was performed under the 12th rib at mid-axillary line, and an 11 mm trocar was inserted. A nephroscope was used to identify the kidney and dissect the perirenal fat. After lower pole exposure, a laparoscopic biopsy forceps was introduced through the nephroscope working channel to collect a renal tissue sample. Results SPRRB was successfully performed in five children. The mean operative time was 32 minutes, and mean estimated blood loss was less than 10 mL. The hospital stay of all patients was two days because they were discharged in the second postoperative day, after remaining at strict bed rest for 24 hours after the procedure. The average number of glomeruli present in the specimen was 31. Conclusion SPRRB is a simple, safe and reliable alternative to open and videolaparoscopic approaches to surgical renal biopsy. .


Assuntos
Criança , Feminino , Humanos , Masculino , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico/instrumentação , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico/métodos , Rim/patologia , Laparoscopia/métodos , Espaço Retroperitoneal/cirurgia , Perda Sanguínea Cirúrgica/prevenção & controle , Tempo de Internação , Duração da Cirurgia , Reprodutibilidade dos Testes , Fatores de Tempo
19.
J Endourol ; 24(3): 445-9, 2010 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-20059352

RESUMO

OBJECTIVES: In a swine model of renal ischemia, we compared the effectiveness of the transurethral retrograde cold saline perfusion technique to the traditional method of renal cooling with ice slush, in achieving adequate parenchymal temperatures for functional preservation of the organ. Physiological and histological effects were also assessed. METHODS: Twenty-four domestic male pigs were sampled into four groups to be submitted to a 60-minute ischemia of the left kidney without cooling, with either one of the two cooling techniques (cold saline retrograde perfusion or ice slush), or sham surgery. All of them had also a concomitant right nephrectomy. Renal cortical and medullary temperatures were recorded throughout the experiment. Urinary output was measured, and serum renal function tests were carried on, pre- and postoperatively. After 5 days, the animals were euthanized and their kidneys were submitted to histological analysis. RESULTS: Mean renal temperature fell in both groups submitted to kidney cooling. With ice slush, a faster drop was observed and a lower minimum temperature was achieved (5.0 degrees C in the cortex and 6.3 degrees C in the medulla, vs. 25.4 degrees C and 24.9 degrees C with retrograde cooling). In the other groups, temperature was unchanged. Urinary output and serum creatinine worsened after the experiment, but without significant differences among groups. The histological analysis showed no differences among the four groups, for the studied ischemia time. CONCLUSIONS: Ice slush and retrograde perfusion of cold saline are both effective for cooling the kidney during ischemia. Ice slush is faster in doing so, and it allows much lower temperatures to be achieved in the renal parenchyma. With ischemia time of 60 minutes, no significant differences on the occurrence of functional and histological alterations were detected, even for the group without a cooling procedure.


Assuntos
Isquemia Fria/métodos , Rim/irrigação sanguínea , Rim/cirurgia , Modelos Animais , Suínos/cirurgia , Animais , Temperatura Corporal , Córtex Renal/irrigação sanguínea , Córtex Renal/cirurgia , Medula Renal/irrigação sanguínea , Medula Renal/cirurgia , Masculino , Resultado do Tratamento
20.
Rio de Janeiro; s.n; ago. 2004. 70 p. ilus, tab, graf.
Tese em Português | LILACS | ID: lil-431270

RESUMO

A dirofilaríase pulmonar humana (DPH) é uma doença que se caracteriza pela presença de nódulo pulmonar não calcificado ocasionado pela presença de vermes imaturos de D. immitis. Normalmente não produz ameaça à saúde do homem por apresentar evolução benigna e, apesar de estar relatada em todos os continentes e ser do conhecimento dos serviços de Radiologia e Pneumologia, poucos nódulos pulmonares retirados chegam ao diagnóstico final, ficando restrito a ser ou não uma neoplasia. Trabalhos prévios baseados na amplificação via reação em cadeia da polimerase (PCR) de regiões repetitivas de rDNA de D. immitis demonstraram a importância da utilização destas como marcadores moleculares espécie-específicos. Este trabalho teve como objetivo gerar subsídios necessários para a criação de um diagnóstico específico para DPH causada por D. immitis, para posterior aplicação de um estudo retrospectivo em materiais de biópsia parafinados contidos nos serviços de Anatomia Patológica. Desenhamos oligonucleotídeos a partir da seqüência do espaçador ribossomal ITS2 de D. immitis, e os utilizamos na técnica da PCR. O produto obtido foi clonado, seqüenciado e, posteriormente analisado com as ferramentas disponíveis no GenBank. Reações de PCR e nested-PCR utilizando como alvo DNA de D. immittis bem como dos nematóides filogeneticamente relacionados Litomosoide sp.,Onchocerca volvulus e Wuchereria bancrofti foram realizadas. Somente para D.immitis obtivemos produto com 405pb que demonstrou similaridade acima de 97 (por cento) com a região ITS2.As reações de “nested-PCR” dos produtos em que se utilizou DNA extraído de espécimes adultos fixados em formalina e emblocados em parafina resultaram em amplicons com aproximadamente 215pb, compatíveis com o tamanho esperado. Este trabalho visou a identificação espécie-específica de D.immitis, em materiais fixados em formalina e emblocados em parafina, sendo ainda o primeiro relato da utilização da técnica de nested-PCR com a mesma finalidade. Foi desenvolvido um diagnóstico molecular que poderá identificar dirofilaríase pulmonar em lesões pulmonares sem confirmação de etiologia. Com essa ferramenta molecular, a frequência dessa parasitose poderá ser melhor avaliada.


Assuntos
Humanos , Dirofilaria , Dirofilariose , Dirofilaria immitis , DNA Intergênico
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