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OBJECTIVES: The objective of this study was to determine the association of the use of extracorporeal cardiopulmonary resuscitation (ECPR) with survival to hospital discharge in pediatric patients with a noncardiac illness category. A secondary objective was to report on trends in ECPR usage in this population for 20 years. DESIGN: Retrospective multicenter cohort study. SETTING: Hospitals contributing data to the American Heart Association's Get With The Guidelines-Resuscitation registry between 2000 and 2021. PATIENTS: Children (<18 yr) with noncardiac illness category who received greater than or equal to 30 minutes of cardiopulmonary resuscitation (CPR) for in-hospital cardiac arrest. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Propensity score weighting balanced ECPR and conventional CPR (CCPR) groups on hospital and patient characteristics. Multivariable logistic regression incorporating these scores tested the association of ECPR with survival to discharge. A Bayesian logistic regression model estimated the probability of a positive effect from ECPR. A secondary analysis explored temporal trends in ECPR utilization. Of 875 patients, 159 received ECPR and 716 received CCPR. The median age was 1.0 [interquartile range: 0.2-7.0] year. Most patients (597/875; 68%) had a primary diagnosis of respiratory insufficiency. Median CPR duration was 45 [35-63] minutes. ECPR use increased over time ( p < 0.001). We did not identify differences in survival to discharge between the ECPR group (21.4%) and the CCPR group (16.2%) in univariable analysis ( p = 0.13) or propensity-weighted multivariable logistic regression (adjusted odds ratio 1.42 [95% CI, 0.84-2.40; p = 0.19]). The Bayesian model estimated an 85.1% posterior probability of a positive effect of ECPR on survival to discharge. CONCLUSIONS: ECPR usage increased substantially for the last 20 years. We failed to identify a significant association between ECPR and survival to hospital discharge, although a post hoc Bayesian analysis suggested a survival benefit (85% posterior probability).
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Reanimação Cardiopulmonar , Oxigenação por Membrana Extracorpórea , Parada Cardíaca , Criança , Humanos , Lactente , Teorema de Bayes , Estudos de Coortes , Parada Cardíaca/terapia , Hospitais , Pontuação de Propensão , Estudos Retrospectivos , Resultado do Tratamento , Pré-EscolarRESUMO
The electrocatalytic properties of Ru complexes are of great technological interest given their potential application in reactions such water splitting and CO2 reduction. In this work, a novel terpyridine-based Ru(II) complex, [RuCl(trpy)(acpy)], trpy = 2,2':6',2''-terpyridine, acpy- = 2-pyridylacetate was synthesized and its spectroscopic, electrochemical and catalytic properties were explored in detail. In dry acetonitrile, the complex exhibits two reduction peaks at -1.95 V and -2.20 V vs. Fc/Fc+, attributed to consecutive 1 e- reduction. Under CO2 atmosphere, a catalytic wave is observed (Eonset = 2.1 V vs. Fc/Fc+), with CO as the main reduction product. Bulk electrolysis reveals a turnover number (TON) of 12 (kobs = 1.5 s-1). In the presence of 1% water, an improvement in the catalytic activity is observed (TONCO = 21 and kobs = 2.0 s-1) and, additionally, formate was also detected (TONHCOO = 7). Spectroelectrochemical experiments allowed the identification of a metallocarboxylate (Ru-COO-) intermediate under anhydrous conditions, while in water, the partial labilization of the acpy- ligand was observed in the course of the catalytic cycle. The experimental data was combined with DFT calculations, allowing the proposal of a catalytic cycle. The results establish important relationships between selectivity, ligand structure and reaction conditions.
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Paragonimiasis is a food-borne infection caused by several species of the Paragonimus fluke. Clinical manifestations can mimic tuberculosis and contribute to diagnostic delay. We report a cluster of paragonimiasis in a community in Ecuador, where active surveillance was set up after detection of the first 2 cases.
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Paragonimíase , Paragonimus , Animais , Diagnóstico Tardio , Equador/epidemiologia , Humanos , Paragonimíase/diagnóstico , Paragonimíase/epidemiologiaRESUMO
A new ruthenium polypyridyl complex, [Ru(bpy)2(acpy)]+ (acpy = 2-pyridylacetate, bpy = 2,2'-bipyridine), was synthesized and fully characterized. Distinct from the previously reported analog, [Ru(bpy)2(pic)]+ (pic = 2-pyridylcarboxylate), the new complex is unstable under aerobic conditions and undergoes oxidation to yield the corresponding α-keto-2-pyridyl-acetate (acpyoxi) coordinated to the RuII center. The reaction is one of the few examples of C-H activation at mild conditions using O2 as the primary oxidant and can provide mechanistic insights with important implications for catalysis. Theoretical and experimental investigations of this aerobic oxidative transformation indicate that it takes place in two steps, first producing the α-hydroxo-2-pyridyl-acetate analog and then the final product. The observed rate constant for the first oxidation was in the order of 10-2 h-1. The reaction is hindered in the presence of coordinating solvents indicating the role of the metal center in the process. Theoretical calculations at the M06-L level of theory were performed for multiple reaction pathways in order to gain insights into the most probable mechanism. Our results indicate that O2 binding to [Ru(bpy)2(acpy)]+ is favored by the relative instability of the six-ring chelate formed by the acpy ligand and the resulting RuIII-OOË- superoxo is stabilized by the carboxylate group in the coordination sphere. C-H activation by this species involves high activation free energies (ΔG = 41.1 kcal mol-1), thus the formation of a diruthenium µ-peroxo intermediate, [(RuIII(bpy)2(O-acpy))2O2]2+via interaction of a second [Ru(bpy)2(acpy)]+ was examined as an alternative pathway. The dimer yields two RuIVîO centers with a low ΔG of 2.3 kcal mol-1. The resulting RuIVîO species can activate C-H bonds in acpy (ΔG = 23.1 kcal mol-1) to produce the coordinated α-hydroxo-2-pyridylacetate. Further oxidation of this intermediate leads to the α-keto-2-pyridyl-acetate product. The findings provide new insights into the mechanism of C-H activation catalyzed by transition-metal complexes using O2 as the sole oxygen source.
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The cultivar BRS Xingu was launched by EMBRAPA in 2015 with the intention of presenting higher productivity. Due to the lack of studies on this cultivar, the objective was to present the physical-chemical, centesimal, and phenolic composition of the BRS Xingu blackberry, its antioxidant capacity, protection against ROS generation, and compare it with other commercialized cultivars such as Guarani, Tupy, and Xavante. The BRS Xingu was prominent regarding anthocyanin and condensed tannin content and superior to the other cultivars. Moreover, BRS Xingu presented higher antioxidant capacity, protection of C. elegans from ROS generation, and soluble solid content when compared to Tupy, which is the most cultivated variety in the world. In the new cultivar, five anthocyanins, five phenolic acids, and ten non-anthocyanin flavonoids were identified. BRS Xingu is presented as an alternative blackberry with potential for industrialization and in natura consumption.
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Antioxidantes/análise , Frutas/química , Fenóis/análise , Rubus/química , Animais , Antocianinas/análise , Antioxidantes/química , Antioxidantes/farmacologia , Brasil , Caenorhabditis elegans/efeitos dos fármacos , Caenorhabditis elegans/metabolismo , Flavonoides/análise , Hidroxibenzoatos/análise , Proantocianidinas/análise , Espécies Reativas de OxigênioRESUMO
Internet of Things (IoT) is an emerging platform in which every day physical objects provided with unique identifiers are connected to the Internet without requiring human interaction. The possibilities of such a connected world enables new forms of automation to make our lives easier and safer. Evidently, in order to keep billions of these communicating devices powered long-term, a self-sustainable operation is a key point for realization of such a complex network. In this sense, energy-harvesting technologies combined with low power consumption ICs eliminate the need for batteries, removing an obstacle to the success of the IoT. In this work, a Radio Frequency (RF) energy harvester tuned at AM broadcast has been developed for low consumption power devices. The AM signals from ambient are detected via a high-performance antenna-free LC circuit with an efficiency of 3.2%. To maximize energy scavenging, the RF-DC conversion stage is based on a full-wave Cockcroft-Walton voltage multiplier (CWVM) with efficiency up to 90%. System performance is evaluated by rating the maximum power delivered into the load via its output impedance, which is around 62 µW, although power level seems to be low, it is able to power up low consumption devices such as Leds, portable calculators and weather monitoring stations.
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Cardiovascular risk is increased in HIV-infected patients and has become a leading cause of morbi-mortality in this population. The purpose of this study is to compare HIV-infected patients on antiretroviral therapy (ART) and ART-naïve HIV-infected patients regarding arterial elasticity. From September 2010 to September 2015, 105 HIV-infected subjects were enrolled, 41 ART-naïve and 64 on ART with stable viral suppression. Elasticity of large and small arteries (LAE and SAE) was assessed by analysis of radial pulse waveforms using a calibrated device. A single set of measurements was performed. Multivariate linear regression models were constructed to estimate independent correlates of arterial elasticity. On-ART and ART-naïve patients were similar with respect to gender, age, body mass index, Framingham cardiovascular risk score, smoking habits, and CD4+ counts. Median time on treatment was 60 months and 79% of patients were on regimens based on non-nucleoside reverse-transcriptase inhibitors. No significant differences in LAE and SAE assessments were found between groups. However, time on ART and cholesterol levels were independently associated with LAE impairment. No association between arterial elasticity and CD4+ counts was found. We conclude that cumulative exposure to ART may play a role on LAE impairment and deserves further investigation.
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Fármacos Anti-HIV/uso terapêutico , Artérias/fisiopatologia , Elasticidade/fisiologia , Infecções por HIV/fisiopatologia , Resistência Vascular/fisiologia , Adulto , Terapia Antirretroviral de Alta Atividade , Estudos Transversais , Feminino , Infecções por HIV/tratamento farmacológico , Humanos , MasculinoRESUMO
Cardiovascular risk is increased in HIV-infected patients and has become a leading cause of morbimortality in this population. The purpose of this study is to compare HIV-infected patients on antiretroviral therapy (ART) and ART-naïve HIV-infected patients regarding arterial elasticity. From September 2010 to September 2015, 105 HIV-infected subjects were enrolled, 41 ART-naïve and 64 on ART with stable viral suppression. Elasticity of large and small arteries (LAE and SAE) was assessed by analysis of radial pulse waveforms using a calibrated device. A single set of measurements was performed. Multivariate linear regression models were constructed to estimate independent correlates of arterial elasticity. On-ART and ART-naïve patients were similar with respect to gender, age, body mass index, Framingham cardiovascular risk score, smoking habits, and CD4+ counts. Median time on treatment was 60 months and 79% of patients were on regimens based on non-nucleoside reverse-transcriptase inhibitors. No significant differences in LAE and SAE assessments were found between groups. However, time on ART and cholesterol levels were independently associated with LAE impairment. No association between arterial elasticity and CD4+ counts was found. We conclude that cumulative exposure to ART may play a role on LAE impairment and deserves further investigation.
El riesgo cardiovascular está incrementado en los pacientes HIV seropositivos y se ha convertido en una de las principales causas de morbimortalidad en esta población. El objetivo de este estudio fue comparar la elasticidad de grandes y pequeñas arterias (LAE y SAE) en pacientes infectados por HIV con y sin terapia antirretroviral. De septiembre de 2010 a septiembre de 2015 se enrolaron 105 pacientes con infección por HIV, 41 vírgenes de antirretrovirales y 64 con tratamiento estable en supresión viral. LAE y SAE fueron evaluados mediante análisis de la onda de pulso radial. Se construyeron modelos de regresión lineal múltiple para evaluar los predictores independientes de la elasticidad arterial. Los grupos en tratamiento y naïve fueron similares con respecto al sexo, edad, índice de masa corporal, índice de Framingham, tabaquismo y recuento de CD4+. La mediana de tiempo en tratamiento antirretroviral fue 60 meses y el 79% de los pacientes recibieron inhibidores no nucleosídicos. No hubo diferencias significativas entre los grupos en los valores de LAE y SAE. Sin embargo, el tiempo en tratamiento y el nivel de colesterol plasmático se asociaron independientemente con deterioro de LAE. No observamos asociaciones entre la elasticidad arterial y los recuentos de CD4+. Concluimos que la exposición acumulada al tratamiento antirretroviral podría contribuir al deterioro de la LAE. Este hallazgo merece ulterior investigación.
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Humanos , Masculino , Feminino , Adulto , Artérias/fisiopatologia , Resistência Vascular/fisiologia , Infecções por HIV/fisiopatologia , Fármacos Anti-HIV/uso terapêutico , Elasticidade/fisiologia , Infecções por HIV/tratamento farmacológico , Estudos Transversais , Terapia Antirretroviral de Alta AtividadeRESUMO
AIM: To assess the proportion of refractive errors in the Mexican population that visited primary care optometry clinics in fourteen states of Mexico. METHODS: Refractive data from 676 856 patients aged 6 to 90y were collected from optometry clinics in fourteen states of Mexico between 2014 and 2015. The refractive errors were classified by the spherical equivalent (SE), as follows: sphere+½ cylinder. Myopia (SE>-0.50 D), hyperopia (SE>+0.50 D), emmetropia (-0.50≤SE≤+0.50), and astigmatism alone (cylinder≥-0.25 D). A negative cylinder was selected as a notation. RESULTS: The proportion (95% confidence interval) among all of the subjects was hyperopia 21.0% (20.9-21.0), emmetropia 40.7% (40.5-40.8), myopia 24.8% (24.7-24.9) and astigmatism alone 13.5% (13.4-13.5). Myopia was the most common refractive error and frequency seemed to increase among the young population (10 to 29 years old), however, hyperopia increased among the aging population (40 to 79 years old), and astigmatism alone showed a decreasing trend with age (6 to 90y; from 19.7% to 10.8%). There was a relationship between age and all refractive errors (approximately 60%, aged 50 and older). The proportion of any clinically important refractive error was higher in males (61.2%) than in females (58.3%; P<0.0001). From fourteen states that collected information, the proportion of refractive error showed variability in different geographical areas of Mexico. CONCLUSION: Myopia is the most common refractive error in the population studied. This study provides the first data on refractive error in Mexico. Further programs and studies must be developed to address the refractive errors needs of the Mexican population.
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Recent findings from the START Trial provided evidence that early initiation of antiretroviral treatment should be implemented as the global standard of care. However, a large proportion of patients are still being diagnosed in late stages. Our objective was to evaluate the temporal trend in the CD4+ cell count at diagnosis during a 13 year period and the factors associated with late HIV diagnosis in asymptomatic individuals tested in the Centre for Prevention, Counselling and Diagnosis of our hospital. It was a retrospective study including all asymptomatic patients with new diagnosis of HIV infection. Very late presenters (VLP) were defined as those with CD4+ counts < 200 and late presenters (LP) with CD4+ < 350 cell/mm3. We also evaluated the proportion of patients diagnosed with CD4+ cell counts below 500 cell/mm3. Between January 2002 and December 2014, 20 263 patients were tested for HIV, 1104 with a positive result of whom 995 asymptomatic individuals were included. Overall, median CD4+ count was 372 cells/mm3 and HIV-RNA 31 145 copies/ml. There was no evidence that the CD4+ count at diagnosis progressively increased over time, nor that the proportion of VLP and LP decreased. In a multivariate model older age, heterosexual transmission and intravenous drug use remained as independent factors associated with LP. In conclusion, late diagnosis of HIV infection remains prevalent among asymptomatic patients, highlighting the need to continue implementing strategies towards early diagnosis.
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Infecções Assintomáticas , Contagem de Linfócito CD4 , Diagnóstico Tardio/tendências , Infecções por HIV/diagnóstico , Adulto , Fatores Etários , Escolaridade , Feminino , Humanos , Modelos Logísticos , Masculino , Estudos Retrospectivos , Fatores de Risco , Comportamento Sexual , Fatores de Tempo , Carga ViralRESUMO
Recent findings from the START Trial provided evidence that early initiation of antiretroviral treatment should be implemented as the global standard of care. However, a large proportion of patients are still being diagnosed in late stages. Our objective was to evaluate the temporal trend in the CD4+ cell count at diagnosis during a 13 year period and the factors associated with late HIV diagnosis in asymptomatic individuals tested in the Centre for Prevention, Counselling and Diagnosis of our hospital. It was a retrospective study including all asymptomatic patients with new diagnosis of HIV infection. Very late presenters (VLP) were defined as those with CD4+ counts < 200 and late presenters (LP) with CD4+ < 350 cell/mm³. We also evaluated the proportion of patients diagnosed with CD4+ cell counts below 500 cell/mm3. Between January 2002 and December 2014, 20 263 patients were tested for HIV, 1104 with a positive result of whom 995 asymptomatic individuals were included. Overall, median CD4+ count was 372 cells/mm3 and HIV-RNA 31 145 copies/ml. There was no evidence that the CD4+ count at diagnosis progressively increased over time, nor that the proportion of VLP and LP decreased. In a multivariate model older age, heterosexual transmission and intravenous drug use remained as independent factors associated with LP. In conclusion, late diagnosis of HIV infection remains prevalent among asymptomatic patients, highlighting the need to continue implementing strategies towards early diagnosis.
Los resultados del estudio START han evidenciado que la iniciación temprana del tratamiento antirretroviral debe ser un estándar global. No obstante, una gran proporción de pacientes aún se diagnostican en etapas tardías. Nuestro objetivo fue evaluar la tendencia en el recuento de CD4+ al diagnóstico de infección por HIV, la proporción de presentadores tardíos entre 2002 y 2014, y los factores asociados con el diagnóstico tardío en pacientes asintomáticos en el Centro de Prevención, Asesoramiento y Diagnóstico de nuestro hospital. Se incluyeron en un estudio retrospectivo todos los sujetos asintomáticos con un diagnóstico de HIV. Se consideraron presentadores muy tardíos (PMT) a aquellos pacientes con CD4+ < 200 y presentadores tardíos (PT) con cifras de CD4+ < 350 células/mm³. Adicionalmente evaluamos la proporción de pacientes diagnosticados con recuentos de CD4+ inferiores a 500 células/mm³. Desde enero 2002 a diciembre de 2014 se testearon para HIV 20 263 pacientes, 1104 con resultado positivo, de los cuales 995 eran asintomáticos. Globalmente, la mediana de CD4+ fue 372 células/mm3 y la de HIV-ARN de 31 145 copias/ml. No hubo evidencia de que el recuento de CD4+ al diagnóstico haya aumentado en el tiempo, ni de disminución de la proporción de PT o PMT. En un modelo multivariado, la mayor edad, la transmisión heterosexual y el uso de drogas intravenosas se asociaron independientemente con PT. En conclusión, el diagnóstico tardío de infección por HIV se mantiene prevalente en pacientes asintomáticos, resaltando la necesidad de continuar implementando estrategias orientadas a favorecer el diagnóstico temprano.
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Humanos , Masculino , Feminino , Adulto , Infecções por HIV/diagnóstico , Contagem de Linfócito CD4 , Diagnóstico Tardio/tendências , Infecções Assintomáticas , Comportamento Sexual , Fatores de Tempo , Modelos Logísticos , Estudos Retrospectivos , Fatores de Risco , Fatores Etários , Carga Viral , EscolaridadeRESUMO
Casiopeína III-Ea (Cas III-Ea(1)) is a copper complex with antiproliferative and antitumor activities, designed to act via alternative mechanisms of action different from Cisplatin. This compound has also been well characterized in preclinical test and pharmacokinetic analysis, being a good candidate for clinical phases. Since very little is known about the processes of biotransformation of therapeutic metal based drugs, this paper report the first approach to the study of the interaction between metal complex Cas III-Ea and cytochromes P450 with the aim to find out possible biotransformation pathways for this complexes and feasible drug-drug interactions. Results showed that Cas III-Ea is a strong irreversible competitive inhibitor of CYP1A1 (IC50 = 7.5 ± 1.0 µM; Ki = 240 nM). The magnitude of values indicate that it is necessary to be taken into account such effect when analyzing possible drug interactions with these new drugs in order to prevent adverse reactions derived from this inhibition.
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Antineoplásicos/farmacologia , Complexos de Coordenação/farmacologia , Inibidores das Enzimas do Citocromo P-450/farmacologia , Sistema Enzimático do Citocromo P-450/metabolismo , Fenantrolinas/farmacologia , Animais , Cinética , Masculino , Microssomos Hepáticos/efeitos dos fármacos , Microssomos Hepáticos/metabolismo , Ratos WistarRESUMO
PURPOSE: To analyze the effect of germline mutations in BRCA1 and BRCA2 on mortality in patients with ovarian cancer up to 10 years after diagnosis. EXPERIMENTAL DESIGN: We used unpublished survival time data for 2,242 patients from two case-control studies and extended survival time data for 4,314 patients from previously reported studies. All participants had been screened for deleterious germline mutations in BRCA1 and BRCA2. Survival time was analyzed for the combined data using Cox proportional hazard models with BRCA1 and BRCA2 as time-varying covariates. Competing risks were analyzed using Fine and Gray model. RESULTS: The combined 10-year overall survival rate was 30% [95% confidence interval (CI), 28%-31%] for non-carriers, 25% (95% CI, 22%-28%) for BRCA1 carriers, and 35% (95% CI, 30%-41%) for BRCA2 carriers. The HR for BRCA1 was 0.53 at time zero and increased over time becoming greater than one at 4.8 years. For BRCA2, the HR was 0.42 at time zero and increased over time (predicted to become greater than 1 at 10.5 years). The results were similar when restricted to 3,202 patients with high-grade serous tumors and to ovarian cancer-specific mortality. CONCLUSIONS: BRCA1/2 mutations are associated with better short-term survival, but this advantage decreases over time and in BRCA1 carriers is eventually reversed. This may have important implications for therapy of both primary and relapsed disease and for analysis of long-term survival in clinical trials of new agents, particularly those that are effective in BRCA1/2 mutation carriers.
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Genes BRCA1 , Genes BRCA2 , Mutação em Linhagem Germinativa , Neoplasias Epiteliais e Glandulares/genética , Neoplasias Epiteliais e Glandulares/mortalidade , Neoplasias Ovarianas/genética , Neoplasias Ovarianas/mortalidade , Idoso , Carcinoma Epitelial do Ovário , Feminino , Humanos , Pessoa de Meia-Idade , Gradação de Tumores , Estadiamento de Neoplasias , Neoplasias Epiteliais e Glandulares/patologia , Neoplasias Ovarianas/patologia , Prognóstico , Análise de SobrevidaRESUMO
Se realizó un estudio de investigación con un diseño cuantitativo, analítico, retrospectivo, transversal, conmetodología de Casos y Controles, seleccionando una muestra de 90 pacientes, a través de un muestreo aleatorio simple de un total de 246 pacientes posquirúrgicos de revascularización miocárdica, los cuales fueron distribuidos en grupo de casos y grupo de controles. En el grupo casos se incluyeron 30 pacientes, mientras que en el grupo control se incluyeron 60 pacientes. Esto fue realizado en el Instituto de Cardiología de Juana Francisca Cabral, de la ciudad de Corrientes, capital. Las operaciones estadísticas utilizadas fueron porcentajes, promedios; y para establecer las asociaciones, OddsRatio, el nivel de significación fue de p< 0,05, se utilizó el programa SPPS, versión 17.0. Cuando se analizó la CEC (Circulación Extracorpórea), en relación al Síndrome Confusional Agudo, se encontró que los pacientes que requirieron CEC tienen 1,75 veces más de probabilidades de desarrollar S.C.A. que los pacientes que no requirieron CEC, con Intervalo de Confianza = 0,71 4,17 y P= 0,162 (NS= no significativo). Al analizar el antecedente de tabaquismo, se observó que los pacientes con antecedente de tabaquismo, tienen 1,83 veces más de probabilidades de desarrollar S.C.A. en el posoperatorio de cirugía de revascularización miocárdica con circulación extracorpórea, que de los pacientes sin antecedente de tabaquismo, con un Intervalo de Confianza = 0,58 3,36 y P= 0,3 (NS= no significativo). Por último, al analizar la variable sexo, se encontró que el grupo de mujeres tienen 2,11 veces más de probabilidades de desarrollar S.C.A., en el posoperatorio de cirugía de revascularización miocárdica con circulación extracorpórea, que los pacientes del sexo masculino, con Intervalo de Confianza = 0,78 7,09 y P= 0,10 (NS= no significativo...
A research study was conducted with quantitative, analytical, retrospective, cross-sectional design with CaseControlmethodology, selecting a sample of 90 patients, through simple random sampling a total of 246 patientspostoperative myocardial revascularization, the which were distributed in the case group and control group. In the case group included 30 patients, whereas in the control group 60 patients were included. This was done at the Institute of Cardiology of Juana Francisca Cabral, city of Corrientes, capital. The statistics operations were used percentages, averages; and to establish partnerships, Odds Ratio, the level ofsignificance was p <0.05, the program was used "SPPS, version 17.0."When the CEC was analyzed in relation to acute confusional syndrome, found that patients who required CPB are1.75 times more likely to develop SCA Patients who required NO CEC, with confidence interval = 0.71 to 4.17 and P= 0.162 (NS = not significant).When analyzing the History of Smoking, it was observed that patients with a history of Tobacco, have 1.83 timesmore likely to develop SCA in the postoperative CABG with cardiopulmonary bypass patients without a history of smoking, a confidence interval = 0.58 to 3.36 and P = 0.3 (NS = not significant). Finally when analyzing the gender variable, it was found that in the group of women, are 2.11 times more likely to develop SCA in the postoperative CABG with cardiopulmonary bypass, that male patients with confidence interval = 0.78 to 7.09 and P = 0.10 (NS = not significant)...
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Humanos , Confusão , Revascularização Miocárdica , PacientesRESUMO
BACKGROUND: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a widely-accepted method for obtaining both benign and malignant mediastinal lymph node samples. We present the results obtained with a modification that simplifies sampling, known as fine-needle capillary sampling or EBUS-FNC. METHODS: A prospective observational study with 44 consecutive patients who underwent EBUS at the University of Navarra Clinic in Pamplona (Spain). All samples were obtained by EBUS-FNC instead of by conventional EBUS-TBNA. No suction was used, and the internal stylus was not completely withdrawn at any time. RESULTS: The examination of the mediastinum by means of EBUS identified the presence of lymphadenopathies or mediastinal masses in 38 patients (86.4%). Samples were taken from more than one lymph node in 23 patients (52.3%). EBUS-FNC provided adequate and representative material for interpretation in all patients, and diagnostic performance was 87%. Sensitivity for the detection of lung cancer with EBUS-FNC was 84%. Mild complications were only recorded in two patients (4.5%). CONCLUSIONS: Our study suggests that EBUS-FNC is a safe technique, comparable to EBUS-TBNA in efficacy, and is able to obtain adequate samples.
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Biópsia por Agulha Fina/métodos , Broncoscopia , Endossonografia , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/patologia , Mediastino/diagnóstico por imagem , Mediastino/patologia , Ultrassonografia de Intervenção , Feminino , Humanos , Biópsia Guiada por Imagem , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Estudos ProspectivosRESUMO
The antiviral activity was tested of different polarity extracts, with differing chemical composition, obtained from aerial parts of Heterophyllaea pustulata Hook f. (Rubiaceae) against Herpes Simplex Virus Type I (HSV-1) and Saint Louis Encephalitis Virus (SLEV). The Vero cell line was employed as a host cell for the antiviral assessment of benzene (Ben), ethyl acetate (EtOAc) and ethanol (EtOH) extracts by means of the Neutral Red uptake assay and plaque reduction test. None of the extracts showed antiviral activity against SLEV. Only the extracts (Ben and EtOAc) with a high content of anthraquinones (AQs) inhibited HSV-1 replication, exhibiting Selectivity Index (SI) values of 2.7 and 2.4, respectively. Therefore, these extracts could be good candidates as natural sources for antiviral drug development against HSV-1.
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Antivirais/química , Antivirais/farmacologia , Extratos Vegetais/química , Extratos Vegetais/farmacologia , Rubiaceae/químicaRESUMO
PURPOSE: We describe a surgical technique to reconstruct the glans secondary to partial penectomy or traumatic partial amputation as well as its complications. We assessed urethral flap vitality and the tumor recurrence rate using this technique. MATERIALS AND METHODS: Glanuloplasty with a urethral flap was done in 10 patients who underwent partial penectomy for penile squamous cell carcinoma. We reconstructed the neoglans with a urethral flap at the same surgical resection. Mean patient age was 61 years (range 18 to 71). Mean followup was 11 months (range 5 to 17). RESULTS: We noted no neomeatal stenosis or flap necrosis secondary to the technique. The early tumor recurrence rate was 10% and the penile curvature rate was 10%. Penile curvature was ventral with no associated penetration difficulty. CONCLUSIONS: This simple, reproducible technique has satisfactory functional and cosmetic results, and an acceptable complication rate for this type of pathological condition.