RESUMO
INTRODUCTION: joint replacement is a highly effective intervention that significantly improves the patient's quality of life, relieves symptoms, restores joint function, and improves mobility and independence. The optimal pain control after total hip replacement has become an important goal of postoperative management. The purpose of this paper is to compare periarticular infiltration (PAI) and lumbar plexus nerve block (LPNB) for the management of post-operative pain in primary total hip arthroplasty because we believe that LPNB provides better analgesic management and lower opioid consumption. We evaluated the opioid usage during hospitalization and the complications derived from either technique. MATERIAL AND METHODS: we randomized 45 patients who underwent elective total hip arthroplasty between January 2019 and January 2020. Two groups were evaluated based on the association of PAI or LPNB. Both as part of a multimodal analgesic regimen. RESULTS: a total of 45 patients were evaluated (22 PAI group, 23 LPNB group). Block group required less opioid administration (p = 0.069). Most of the patients in both groups reported mild/moderate pain. The LPNB group had lower pain scale with physiotherapy. We did not have complications derived from either technique. CONCLUSION: lumbar plexus nerve block (LPNB) in patients undergoing total hip arthroplasty provides better pain management and reduced opioid consumption compared to PAI. The performance of this technique does not delay the beginning of physiotherapy and there were not any issues with the patient's recovery.
INTRODUCCIÓN: la artroplastía es una intervención altamente eficaz que mejora de manera significativa la calidad de vida del paciente, alivia los síntomas, restaura la función articular y mejora la movilidad e independencia. El control óptimo del dolor después de la artroplastía total de cadera se ha convertido en un objetivo importante del tratamiento postoperatorio. El propósito de este trabajo es comparar la infiltración periarticular (IPA) y el bloqueo nervioso del plexo lumbar (BNPL) para el manejo del dolor postoperatorio en la artroplastía total de cadera primaria, ya que creemos que la BNPL proporciona mejor manejo analgésico y menor consumo de opioides. Se evaluó el uso de opioides durante la hospitalización y las complicaciones derivadas de cada técnica. MATERIAL Y MÉTODOS: fueron aleatorizados 45 pacientes tratados con artroplastía total de cadera electiva entre Enero de 2019 y Enero de 2020 en dos grupos: IPA o BNPL. Ambos como parte de un régimen analgésico multimodal. RESULTADOS: veintidós en el grupo IPA y 23 en el grupo BNPL. El grupo de bloqueo requirió menos administración de opioides (p = 0.069). La mayoría de los pacientes de ambos grupos reportaron dolor leve/moderado. El grupo de BNPL tuvo menor escala de dolor al realizar fisioterapia. No tuvimos complicaciones derivadas de ninguna de las técnicas analgésicas. CONCLUSIÓN: el BNPL en pacientes sometidos a artroplastía total de cadera proporciona mejor manejo del dolor y una reducción del consumo de opioides en el postoperatorio en comparación con la IPA. La realización de esta técnica no retrasa el inicio de la fisioterapia y no hubo problemas con la recuperación del paciente.
Assuntos
Artroplastia de Quadril , Bloqueio Nervoso , Humanos , Analgésicos Opioides/uso terapêutico , Qualidade de Vida , Estudos Prospectivos , Método Simples-Cego , Dor , Plexo LombossacralRESUMO
Resumen: Introducción: La artroplastía es una intervención altamente eficaz que mejora de manera significativa la calidad de vida del paciente, alivia los síntomas, restaura la función articular y mejora la movilidad e independencia. El control óptimo del dolor después de la artroplastía total de cadera se ha convertido en un objetivo importante del tratamiento postoperatorio. El propósito de este trabajo es comparar la infiltración periarticular (IPA) y el bloqueo nervioso del plexo lumbar (BNPL) para el manejo del dolor postoperatorio en la artroplastía total de cadera primaria, ya que creemos que la BNPL proporciona mejor manejo analgésico y menor consumo de opioides. Se evaluó el uso de opioides durante la hospitalización y las complicaciones derivadas de cada técnica. Material y métodos: Fueron aleatorizados 45 pacientes tratados con artroplastía total de cadera electiva entre Enero de 2019 y Enero de 2020 en dos grupos: IPA o BNPL. Ambos como parte de un régimen analgésico multimodal. Resultados: Veintidós en el grupo IPA y 23 en el grupo BNPL. El grupo de bloqueo requirió menos administración de opioides (p = 0.069). La mayoría de los pacientes de ambos grupos reportaron dolor leve/moderado. El grupo de BNPL tuvo menor escala de dolor al realizar fisioterapia. No tuvimos complicaciones derivadas de ninguna de las técnicas analgésicas. Conclusión: El BNPL en pacientes sometidos a artroplastía total de cadera proporciona mejor manejo del dolor y una reducción del consumo de opioides en el postoperatorio en comparación con la IPA. La realización de esta técnica no retrasa el inicio de la fisioterapia y no hubo problemas con la recuperación del paciente.
Abstract: Introduction: Joint replacement is a highly effective intervention that significantly improves the patient's quality of life, relieves symptoms, restores joint function, and improves mobility and independence. The optimal pain control after total hip replacement has become an important goal of postoperative management. The purpose of this paper is to compare periarticular infiltration (PAI) and lumbar plexus nerve block (LPNB) for the management of post-operative pain in primary total hip arthroplasty because we believe that LPNB provides better analgesic management and lower opioid consumption. We evaluated the opioid usage during hospitalization and the complications derived from either technique. Material and methods: We randomized 45 patients who underwent elective total hip arthroplasty between January 2019 and January 2020. Two groups were evaluated based on the association of PAI or LPNB. Both as part of a multimodal analgesic regimen. Results: A total of 45 patients were evaluated (22 PAI group, 23 LPNB group). Block group required less opioid administration (p = 0.069). Most of the patients in both groups reported mild/moderate pain. The LPNB group had lower pain scale with physiotherapy. We did not have complications derived from either technique. Conclusion: Lumbar plexus nerve block (LPNB) in patients undergoing total hip arthroplasty provides better pain management and reduced opioid consumption compared to PAI. The performance of this technique does not delay the beginning of physiotherapy and there were not any issues with the patient's recovery.
RESUMO
Hepatitis E virus (HEV) genotype 3 is the most prevalent HEV genotype in Europe causing mostly asymptomatic infections in humans, but can also sporadically cause severe acute hepatitis, chronic liver disease, chronic hepatitis in immunocompromised patients and extra-hepatic manifestations. Although much is today known about the swine reservoir, no information is available on the occurrence of HEV from widely distributed deer species in Portugal. Here, we investigated the presence and characterized HEV in free-living deer in Portugal by screening stools from red deer (Cervus elaphus) (n = 95) and fallow deer (Dama dama) (n = 35) for HEV by a broad-spectrum nested RT-PCR, followed by sequencing and phylogenetic analysis. Two red deer females, sampled in central Portugal, showed to be shedding HEV (2.1%; 95% confidence interval: 0.58-7.35). Sequencing and genetic characterization showed that these two deer HEV sequences were 98.96% identical to each other, being both of HEV genotype 3 subgenotype 3e. The increasing numbers and distribution of deer in Portugal and the zoonotic features of the circulating HEV genotype 3 subgenotype 3e highlights the importance of continued surveillance directed to food-borne diseases, especially those involving wild animals and deer in particular.
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Cervos , Vírus da Hepatite E , Hepatite E , Doenças dos Suínos , Animais , Feminino , Genótipo , Hepatite E/epidemiologia , Hepatite E/veterinária , Vírus da Hepatite E/genética , Humanos , Filogenia , Portugal/epidemiologia , SuínosRESUMO
1. The study was carried out to evaluate the effect of stocking density on performance, litter moisture, Eimeria oocyst shedding, intestinal and foot lesions in broilers.2. A total of 192 1-d-old male Cobb broilers were distributed with three different stocking densities (6, 8 or 10 chickens/m2) with outdoor access and eight replicates in a completely randomised design over two periods. Productive parameters were measured from 3 to 7 weeks of age.3. Oocyst counts (OPG) in both excreta and litter were performed at 3, 4 and 5 weeks of age. Intestinal and foot pad lesions were evaluated at 7 weeks old. The stocking density of 6 birds/m2 had the highest body weights (P < 0.05) (2129 ± 37.67, 2759 ± 50.82 and 3167 ± 75.64 g at weeks 5, 6 and 7 of age, respectively).4. Feed intake decreased with increasing stocking density at week 3 (r = -0.57), 4 (r = -0.48), 5 (r = -0.84), 6 (r = -0.68) and 7 (r = -0.65) of age (P < 0.05). Birds with stocking densities of 8 and 10/m2 consumed, respectively, up to 11% and 19.5% less feed than the lower stocking density groups.5. Stocking density affected (P < 0.05) feed conversion (1.61, 1.49 and 1.46) and litter moisture (40.88, 52.60 and 56.19%) at 3 weeks of age. Neither carcase yield nor mortality was different between densities (P > 0.05). Likewise, there was no effect of stocking density on OPG neither in excreta nor in litter, intestinal lesions, or foot pad and hock injuries (P > 0.05).6. In conclusion, the higher stocking density decreased both the feed intake and the live weight in broilers, but there were no effects in the number of Eimeria OPG in excreta or litter, neither intestinal lesions nor in foot pad injuries.
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Galinhas , Eimeria , Criação de Animais Domésticos , Animais , Abrigo para Animais , Masculino , Clima TropicalRESUMO
Studies of the current Chilean population performed using classical genetic markers have established that the Chilean population originated primarily from the admixture of European people, particularly Spaniards, and Amerindians. A socioeconomic-ethno-genetic cline was established soon after the conquest. Spaniards born in Spain or Chile occupied the highest Socioeconomic Strata, while Amerindians belonged to the lowest. The intermediate strata consisted of people with different degrees of ethnic admixture; the larger the European admixture, the higher the Socioeconomic Level. The present study of molecular genomic markers sought to calculate the percentage of Amerindian admixture and revealed a finer distribution of this cline, as well as differences between two Amerindian groups: Aymara and Mapuche. The use of two socioeconomic classifications - Class and Socioeconomic Level - reveals important differences. Furthermore, Self-reported Ethnicity (self-assignment to an ethnic group) and Self-reported Ancestry (self-recognition of Amerindian ancestors) show variations and differing relationships between socioeconomic classifications and genomic Amerindian Admixture. These data constitute a valuable input for the formulation of public healthcare policy and show that the notions of Ethnicity, Socioeconomic Strata and Class should always be a consideration in policy development.
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Etnicidade , Genômica , Chile , Frequência do Gene , Marcadores Genéticos , Humanos , Indígenas Sul-Americanos/genética , EspanhaRESUMO
Pancreatic ductal adenocarcinoma (PDAC) is one of the most intractable and devastating malignant tumors. Epigenetic modifications such as DNA methylation and histone modification regulate tumor initiation and progression. However, the contribution of histone variants in PDAC is unknown. Here, we demonstrated that the histone variant H2A.Z is highly expressed in PDAC cell lines and PDAC patients and that its overexpression correlates with poor prognosis. Moreover, all three H2A.Z isoforms (H2A.Z.1, H2A.Z.2.1, and H2A.Z.2.2) are highly expressed in PDAC cell lines and PDAC patients. Knockdown of these H2A.Z isoforms in PDAC cell lines induces a senescent phenotype, cell cycle arrest in phase G2/M, increased expression of cyclin-dependent kinase inhibitor CDKN2A/p16, SA-ß-galactosidase activity and interleukin 8 production. Transcriptome analysis of H2A.Z-depleted PDAC cells showed altered gene expression in fatty acid biosynthesis pathways and those that regulate cell cycle and DNA damage repair. Importantly, depletion of H2A.Z isoforms reduces the tumor size in a mouse xenograft model in vivo and sensitizes PDAC cells to gemcitabine. Overexpression of H2A.Z.1 and H2A.Z.2.1 more than H2A.Z.2.2 partially restores the oncogenic phenotype. Therefore, our data suggest that overexpression of H2A.Z isoforms enables cells to overcome the oncoprotective barrier associated with senescence, favoring PDAC tumor grow and chemoresistance. These results make H2A.Z a potential candidate as a diagnostic biomarker and therapeutic target for PDAC.
Assuntos
Adenocarcinoma/genética , Carcinoma Ductal Pancreático/genética , Inibidor p16 de Quinase Dependente de Ciclina/genética , beta-Galactosidase/genética , Adenocarcinoma/tratamento farmacológico , Adenocarcinoma/patologia , Envelhecimento/genética , Animais , Carcinoma Ductal Pancreático/tratamento farmacológico , Carcinoma Ductal Pancreático/patologia , Transformação Celular Neoplásica/genética , Dano ao DNA/efeitos dos fármacos , Metilação de DNA/genética , Reparo do DNA/efeitos dos fármacos , Desoxicitidina/análogos & derivados , Desoxicitidina/farmacologia , Resistencia a Medicamentos Antineoplásicos/genética , Epigênese Genética/genética , Xenoenxertos , Histonas/genética , Humanos , Camundongos , GencitabinaRESUMO
BACKGROUND: Immune checkpoint inhibitors (ICI) have been associated with several immune-related adverse events, including sarcoidosis-like reactions (SLR). SLR, which has a low prevalence but an increasing incidence, is similar to sarcoidosis in terms of histology, and clinical and radiological manifestations. The most commonly affected organs are hilar and mediastinal lymph nodes and skin. SLR is an exclusion diagnosis, so a lymph node biopsy can be useful to distinguish between tumor progression and SLR, particularly in tumors in which nodal involvement is very common. PATIENTS AND METHODS: We performed a retrospective analysis of SLR in all cancer patients receiving ICIs in our institution between January 2016 and June 2020. RESULTS: Among the 1063 treated patients, seven experienced SLR, four of whom were symptomatic (cough, skin lesions, arthralgia), with time to onset ranging from 1.5 to 6.7 months after ICI initiation. All seven patients had bilateral hilar lymphadenopathy, and granulomatous reactions in five of the six patients with lymph node biopsies. SLR improved in all patients, including four patients who continued with ICI. Three patients received corticosteroids and/or stopped ICI therapy. Four of these patients had partial responses at the time SLR was identified. CONCLUSION: Management of SLR lacks a consensus recommendation, although corticosteroids and/or stopping the ICI are generally implemented. The potential consequences of stopping anticancer treatment should be taken into consideration, particularly in the absence of clear management recommendations.
Assuntos
Toxidermias/etiologia , Inibidores de Checkpoint Imunológico/efeitos adversos , Linfadenopatia/induzido quimicamente , Neoplasias/tratamento farmacológico , Sarcoidose/induzido quimicamente , Adulto , Idoso , Feminino , Hospitais , Humanos , Inibidores de Checkpoint Imunológico/uso terapêutico , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , EspanhaRESUMO
The unique circumstances created by the COVID-19 pandemic pose serious challenges to mood stability and emotional regulation at all ages. Although many people tend to react resiliently to stress, others appear to display emotional anxiety and depression-related symptoms. In this study, we carried out a survey (N = 10,053) during the first week of the general lockdown (quarantine) in Argentina to measure early affective reactions in Argentine adults. Respondents showed substantial anxious and depressive symptoms, with 33% and 23% of participants reporting possible depressive and anxious syndromes, respectively, with the youngest group (18 to 25 y.o.) showing the highest prevalence of symptoms. Even if prior mental health problems predisposed or aggravated the reaction, participants without prior complaints showed signs of psychological impact. Using linear regression, the most important independent variables related to depressive symptoms were the feeling of loneliness followed by daily stress. In the case of anxious states, the strongest variables were negative repetitive thinking and feeling of loneliness. Other psychological, economic, and social factors are discussed. This study is in line with previous literature that highlight the importance of the psychological impact of pandemics, but additionally demonstrates that these reactions are present at a large scale immediately after the start of quarantine with very low infectious rates as an early anticipatory adaptive reaction leading to potential negative outcomes from adjustment disorders to major disorders. In addition, the present results provide potentially relevant information about sudden environmental impacts on affective states and specific pathways for anxiety and depression to be expressed. We end by discussing implications for public policy based on considering the most vulnerable groups.
Assuntos
COVID-19 , Pandemias , Adulto , Ansiedade/epidemiologia , Argentina/epidemiologia , Controle de Doenças Transmissíveis , Depressão , Humanos , Saúde Mental , Quarentena , SARS-CoV-2 , Estresse Psicológico/epidemiologiaRESUMO
Perfluorohexane sulfonate (PFHxS) is one of the most abundant perfluorinated compounds in the environment. Exposure to this compound has been correlated to a decrease in human fertility, although the molecular and cellular mechanisms underlying this correlation have not been described. The adverse reproductive effects of PFHxS could be based on alterations in oocyte maturation, the process rendering oocytes competent for fertilization. The aim of this study was to evaluate the effect of PFHxS on porcine oocyte viability and maturation in vitro, as well as on gap-junctional intercellular communication (GJIC) in cumulus-oocyte complexes (COCs), oocyte mitochondrial membrane potential (mΔΨ) and DNA damage in cumulus cells, as possible mechanisms of action. PFHxS caused cytotoxicity (medium lethal concentration, LC50â¯=â¯329.1⯵M) and inhibition of oocyte maturation (medium inhibitory concentration, MIC50â¯=â¯91.68⯵M). GJIC was not affected in exposed COCs. However, the mitochondrial membrane potential was significantly decreased in PFHxS-exposed oocytes at the germinal vesicle breakdown (GVBD) stage. In addition, exposure to PFHxS induced DNA damage in cumulus cells. Thus, inhibition of oocyte maturation by PFHxS could be attributed to a decreased oocyte mΔΨ at the GVBD and to DNA damage of the cumulus cells that support the oocyte.
Assuntos
Células do Cúmulo/efeitos dos fármacos , Ácidos Sulfônicos/toxicidade , Animais , Comunicação Celular/efeitos dos fármacos , Diferenciação Celular/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Células Cultivadas , Células do Cúmulo/fisiologia , Dano ao DNA , Feminino , Fluorocarbonos , Junções Comunicantes/efeitos dos fármacos , Potencial da Membrana Mitocondrial/efeitos dos fármacos , Oócitos/efeitos dos fármacos , Oócitos/fisiologia , SuínosRESUMO
The systematic adoption of the histopathologic criteria provided by the 2016 update of the WHO classification of brain tumors has markedly increased the relative proportion of atypical and anaplastic meningiomas. These tumors exhibit a much greater recurrence rate compared to benign meningiomas, which negatively impacts survival. In recent years, the publication of numerous retrospective case series, yet no randomized controlled trials, on the impact of radiation therapy in non-benign meningioma, has yielded conflicting evidence. At present, maximum safe resection, including the dural attachment, is the preferred primary treatment modality for all types of meningiomas. Adjuvant radiotherapy is currently recommended for subtotally resected grade II and for all grade III meningiomas. However, in grade II meningiomas achieving complete resection, close radiologic and clinical observation is a feasible option. Despite the great amount of non-benign meningiomas available and eligible for trials, there is a striking lack of prospective studies testing adjuvant therapies against observation for this subset of patients. An updated and systematic literature review is provided on the effectiveness and indications of radiotherapy on grade II and III meningiomas.
Assuntos
Neoplasias Meníngeas/radioterapia , Meningioma/radioterapia , Recidiva Local de Neoplasia/radioterapia , Radioterapia Adjuvante , Humanos , Neoplasias Meníngeas/classificação , Neoplasias Meníngeas/patologia , Neoplasias Meníngeas/cirurgia , Meningioma/classificação , Meningioma/patologia , Meningioma/cirurgia , Gradação de Tumores , Recidiva Local de Neoplasia/patologia , Recidiva Local de Neoplasia/cirurgia , Estudos Prospectivos , Organização Mundial da SaúdeRESUMO
The molecular biology of human glioma is a complex and fast-growing field in which basic research needs to meet clinical expectations in terms of anti-tumor efficacy. Although much effort is being done in molecular biology research, significant contribution to the quality of life and overall survival still lacks. The vastness of molecular biology literature makes it virtually impossible for clinicians to keep up to date in the field. This paper reviews some practical concepts regarding glioma tumorigenesis from the clinician's perspective. Five main aspects are discussed: major intracellular signaling pathways involved in glioma formation; genomic, epigenetic and transcriptomic relevant features of glioma; the prognostic and predictive values of molecular markers according to the new WHO classification of glial tumors; the importance of molecular and cellular heterogeneity in glioblastoma, responsible for its therapy resistance; and the interaction between glioma and the immune system, in view of the novel and promising targeted therapies.
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Neoplasias Encefálicas/genética , Glioma/genética , Neoplasias Encefálicas/irrigação sanguínea , Neoplasias Encefálicas/etiologia , Neoplasias Encefálicas/patologia , Glioma/irrigação sanguínea , Glioma/etiologia , Glioma/patologia , Humanos , Biologia Molecular , Transdução de Sinais/fisiologia , TranscriptomaRESUMO
Dentro de los daños intencionales en adolescentes, las autoagresiones se han convertido en los últimos años en un tema de interés clínico, social y público, en constante investigación. Una conducta autolesiva es toda conducta autodeliberada destinada a producir daño físico directo en el cuerpo, sin la intención de provocar la muerte. Objetivos: Describir los casos de pacientes con autoagresiones que fueron atendidos por el equipo de adolescencia (clínica pediátrica y salud mental) en el Hospital Garrahan desde el año 2015 al 2017. Diseño observacional, descriptivo y retrospectivo. Se incluyeron todos los adolescentes que fueron evaluados en conjunto por el servicio de adolescencia y salud mental. Resultados: Se atendieron 17 casos, rango de edad 12 a 16 años, 14 mujeres. Los motivos de consulta fueron variados, el principal mecanismo de autoagresión elegido fue cortes superficiales en antebrazo y piernas. La mayoría presentó como factor de riesgo principal conflictos familiares, coincidiendo con la bibliografía revisada. Un abordaje integral por personal capacitado en un servicio amigable es necesario para no perder la oportunidad de pesquisar estas situaciones. Así, mediante un trabajo interdisciplinario disminuir los riesgos que conllevan estas conductas (AU)
Within intentional harm in adolescents, over the last years selfinjury has become an issue of clinical, social, and public interest in ongoing research. Self-injurious behavior is all deliberate behavior aimed at producing direct physical harm to the body, without the intention to cause death. Objectives: To describe cases of patients with self-injurious behavior seen by the adolescents team (pediatrics and mental health) at Garrahan Hospital between 2015 and 2017. A retrospective, observational, descriptive study was conducted. All adolescents seen together by the Departments of Adolescence and Mental Health were included in the study. Results: 17 patients were evaluated, with ages ranging from 12 to 16 years; 14 were girls. Main complaints were varied. The main mechanism of self-injury were superficial cuts on the forearms and legs. The main risk factor in the majority of patients were family conflicts, as reported in the literature. A comprehensive approach by trained personnel from a friendly team is necessary so as not to lose the opportunity to screen this type of situations. An interdisciplinary approach may reduce the risks associated with these behaviors (AU)
Assuntos
Humanos , Adolescente , Ferimentos Penetrantes/psicologia , Comportamento do Adolescente , Comportamento Autodestrutivo/psicologia , Comportamento Autodestrutivo/epidemiologia , Centros de Atenção Terciária , Estudos Retrospectivos , Estudo ObservacionalRESUMO
Oxygen-enriched atmospheres applied as periodic pulses increased conidia production from entomopathogenic fungi in agar surface cultures. However, this advantage has not been obtained in solid-state cultures (SSC), probably as a result of different biomass production between both culture systems. In this work, the biomass formation from two Isaria strains was limited in SSC using 5, 2·5 and 1 initial grams of substrate (gds). In the system with 5 gds, conidia production decreased in 26% oxygen-enriched pulses compared to the normal atmosphere. Conversely, 26% oxygen pulses increased conidiation up to one order magnitude in systems with 2·5 and 1 gds, respective to the normal atmosphere. These results were explained by oxygen depletion and high CO2 accumulation in the 5 gds system. Whereas in systems with 2·5 or 1 gds, oxygen levels remained high enough to stimulate conidiation. These results were attributed to the headspace volume:gds ratio, which is suggested to be ≥48 ml per gds. This ratio is proposed as a scaling-up criterion for bioreactor design when oxygen-enriched pulses are used in SSC for improvement of conidia production. SIGNIFICANCE AND IMPACT OF THE STUDY: Oxygen-enriched atmospheres applied as periodic pulses increase conidiation in entomopathogenic fungi (EF). However, this remained restricted to agar surface cultures, since conidiation decreased when carried out in solid-state culture (SSC) which is used as large-scale production system. We identified that in SSC the ratio between the headspace volume containing 26% oxygen-enriched pulses and the grams of substrate determines the conidiation response to oxygen-enriched pulses. For the first time, oxygen-enriched pulses increased conidiation in SSC respective to the normal atmosphere in four EF. This ratio is proposed as a bioreactor criterion design for large-scale conidia production of EF using oxygen-enriched pulses.
Assuntos
Hypocreales/crescimento & desenvolvimento , Oxigênio/farmacologia , Esporos Fúngicos/crescimento & desenvolvimento , Biomassa , Reatores Biológicos/microbiologia , Meios de CulturaRESUMO
INTRODUCTION: Cutaneus squamous cell carcinoma (SCC) is the second most common type of nonmelanoma skin cancer. SCC is a malignant neoplasm of the skin characterized by aberrant proliferation of keratinocytes. PRESENTATION CASE: We report multidisciplinary surgical management of a 36-year-old male who presented with a huge cutaneous protruding tumor of the cervicothoracic wall. Clinically, he presented with a growing mass on the anterior cervicothoracic wall 3 years ago. Microscopic examination revealed SCC. He underwent complete excision of the lesion. The patient neglected attending our oncological department for receiving chemotherapy. Today, one year after surgery, he is alive without evidence of disease recurrence. DISCUSSION: SCC treatment depends on location of the lesion, involvement of neighboring structures, functional level of the patient, and the patient's acceptance of the proposed management strategy. CONCLUSION: We conclude that SCC can grow to a huge size if left untreated. Surgery by a multidisciplinary surgical team is the primary mode of treatment, followed by chemotherapy if necessary.
RESUMO
Artisanal and small-scale gold mining (ASGM) is currently one of the largest anthropogenic sources of mercury (Hg) to the atmosphere and a significant source to downstream terrestrial aquatic systems. Given the potential toxicity of Hg when it is released to aquatic ecosystems, both scientific and regulatory communities have interest in the development of tools and methods for understanding the fate and transport of Hg in the environment. Although Hg isotopes are applied extensively to trace other anthropogenic point sources of Hg in aquatic ecosystems, few studies have used isotopic analyses to investigate the downstream impacts of ASGM. Furthermore, these studies are currently limited by relatively sparse Hg isotopic analyses on ASGM materials. In this study, ASGM samples from Portovelo-Zaruma (Ecuador), representing various stages of the processing of low-grade gold-bearing ores, were analyzed for Hg concentrations and stable isotope ratios. These data were used to assess the isotopic variability of the ASGM endmember and confirm the results of prior isotopic analyses of ASGM materials and downstream sediments from Portovelo-Zaruma. While the Hg concentrations of the ASGM samples varied significantly, isotopic analyses revealed a limited range of signatures that was characterized by relatively heavy mass-dependent fractionation (MDF) with little to no significant mass-independent fractionation (MIF). The signatures of ASGM samples analyzed in this study matched well with previously reported ASGM samples from Portovelo-Zaruma as well as downstream sediments (for up to 120â¯km). Furthermore, the overall Hg isotopic compositions of potential ASGM endmembers are distinct from typical compositions observed in freshwater ecosystems (e.g., from soil erosion, atmospheric deposition), allowing Hg isotopes to be a powerful tool in tracing downstream Hg contamination from ASGM.
RESUMO
Ependymoma is an uncommon neuroepithelial tumor that may arise anywhere within the neuroaxis, both in children and in adults. It has been classically graded upon histopathological features, yet with limited clinical utility. Recently, DNA methylation profiling has provided a novel classification of ependymoma in nine molecular subgroups. This stratification method harbors prognostic value with supratentorial RELA-fusion and posterior fossa group A tumors showing a significantly shorter survival compared to the rest. Currently, the treatment of choice involves maximal safe resection and, in cases of residual disease, adjuvant conformal radiotherapy. Second-look surgery is also a feasible and recommended option for incompletely resected tumors. The role of chemotherapy is not yet established and can be considered in infants and children with relapsing disease or prior to re-intervention. Although targeted agents do not seem to play a role as adjuvant therapy, they are currently being tested for recurrent disease.