RESUMO
BACKGROUND: With the goal of achieving immune system reset, autologous hematopoietic stem cell transplantations have been performed in patients with multiple sclerosis (MS). MATERIAL AND METHODS: Two hundred and eighty-six consecutive patients with MS were autografted in a single center using non-frozen peripheral blood stem cells (PBSCs), on an outpatient basis and conditioning with cyclophosphamide and rituximab. The protocol was registered in ClinicalTrials.gov identifier NCT02674217. RESULTS: One hundred and ninety-four females and 92 males were included; the median age was 47. All procedures were started on an outpatient basis and only 8 persons needed to be admitted to the hospital during the procedure. In order to obtain at least 1 × 106/kg viable CD34 cells, 1-4 aphereses were performed (median 1). The total number of viable CD34+ cells infused ranged between 1 and 19.2 × 106/kg (median 4.6). Patients recovered above 0.5 × 109/L absolute granulocytes on median day 8 (range 0-12). Two individuals needed red blood cells but none needed platelet transfusions. There were no transplant-related deaths and the 128-month overall survival of the patients is 100%. In 82 persons followed up for 3 or more months, the Expanded Disability Status Scale diminished from a mean of 5.2-4.9, the best results being obtained in relapsing-remitting and primary progressive MS. CONCLUSIONS: It is possible to conduct autotransplants for patients with MS employing non-frozen PBSCs and outpatient conduction. Additional information is needed to assess the efficacy of these procedures in the treatment of patients with MS.
Assuntos
Esclerose Múltipla/terapia , Transplante de Células-Tronco de Sangue Periférico/métodos , Adulto , Assistência Ambulatorial , Remoção de Componentes Sanguíneos , Criopreservação , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Condicionamento Pré-Transplante , Transplante Autólogo , Resultado do Tratamento , Adulto JovemRESUMO
In this study single-chamber microbial electrolysis cells (MECs) were applied to treat cheese whey (CW), an industrial by-product, and recover H2 gas. Firstly, this substrate was fed directly to the MEC to get the initial feedback about its H2 generation potential. The results indicated that the direct application of CW requires an adequate pH control to realize bioelectrohydrogenesis and avoid operational failure due to the loss of bioanode activity. In the second part of the study, the effluents of anaerobic (methanogenic) digester and hydrogenogenic (dark fermentative H2-producing) reactor utilizing the CW were tested in the MEC process (representing the concept of a two-stage technology). It turned out that the residue of the methanogenic reactor - with its relatively lower carbohydrate- and higher volatile fatty acid contents - was more suitable to produce hydrogen bioelectrochemically. The MEC operated with the dark fermentation effluent, containing a high portion of carbohydrates and low amount of organic acids, produced significant amount of undesired methane simultaneously with H2. Overall, the best MEC behavior was attained using the effluent of the methanogenic reactor and therefore, considering a two-stage system, methanogenesis is an advisable pretreatment step for the acidic CW to enhance the H2 formation in complementary microbial electrohydrogenesis.
Assuntos
Fontes de Energia Bioelétrica/microbiologia , Queijo , Eletrólise/métodos , Hidrogênio/metabolismo , Metano/biossíntese , Soro do Leite/química , Reatores Biológicos/microbiologia , Ácidos Graxos Voláteis/metabolismo , Metano/análiseRESUMO
BACKGROUND: Intramuscular myxoma is a rare benign soft tissue tumour of mesenchymal origin, which appears as a painless mass of slow growth. Early diagnosis is important in order to differentiate it from other entities, especially soft tissue sarcoma. CLINICAL CASES: Two cases, both women with a mean age of 52.5 years (range 40-65) are presented. The first was seen due to growth of a gluteal mass, and the second by coccydynia. Computed tomography and nuclear magnetic resonance were the diagnostic tests of choice. In one case, where there was a single but large lesion, radical extirpation of the gluteal muscle was chosen. In the other case, in which the lesions were multiple, individualised excision of cysts was performed. Postoperative functional limitation was low in both types of surgery, with good oncological results being obtained. CONCLUSION: Intramuscular myxomas are benign lesions. There are no cases of malignancy or recurrence due to incomplete resection. It has to be determined whether they are single or multiple, since in the latter case, they could be due to syndromes such as Mazabraud syndrome, which is associated with bone fibrous dysplasia, or Albright syndrome that is also associated with pigmented skin spots.
Assuntos
Neoplasias Musculares/diagnóstico , Neoplasias Musculares/cirurgia , Mixoma/diagnóstico , Mixoma/cirurgia , Adulto , Idoso , Diagnóstico Diferencial , Feminino , HumanosRESUMO
Objetivo. Se analizaron los significados atribuidos a las experiencias de pérdidas múltiples y la elaboración del duelo en personas desplazadas que habitan actualmente en la ciudad de Medellín (Colombia). Método. Estudio descriptivo con enfoque fenomenológico-hermenéutico. Participaron voluntariamente 18 personas en situación de desplazamiento, quienes reconstruyeron su experiencia en entrevistas semiestructuradas. El análisis de los datos se realizó mediante el programa Atlas Ti. Resultados. El desplazamiento forzado causa múltiples pérdidas físicas y simbólicas. El dolor, la incertidumbre, la desconfianza, el miedo, las expresiones somáticas y las conductas de aislamiento son respuestas comunes frente a esta experiencia y enmarcan los significados construidos alrededor de ella. El duelo sigue un proceso de elaboración parcial de acuerdo con las características personales, el apoyo social y los recursos simbólicos y económicos disponibles en los lugares de reasentamiento. Conclusión. La fuerza del apego al campo y a los otros, las características personales, los aspectos contextuales y la forma en que el vínculo se rompe permiten comprender las posibilidades y los límites para la reconstrucción de la vida. Algunas pérdidas, generalmente aquellas asociadas con experiencias de horror, permanecen para los afectados como heridas imposibles de sanar.
Objective. The meaning attributed to the experiences of multiple losses, and the handling of grief in displaced persons in Medellin (Colombia) were analyzed. Method. Using a phenomenological-hermeneutical approach, a descriptive, qualitative study was carried out. Eighteen displaced persons, who voluntarily participated, reconstructed their experiences in semi-structured interviews. Atlas Ti software was used for data analysis. Results. Forced displacement causes multiple loss, both physical and symbolic. Pain, uncertainty, distrust, fear, somatic manifestations and isolation behavior are common responses to this experience and form a framework of the meanings built around it. Grief follows a process of partial management, according to personal characteristics, social support and the symbolic and economic resources available at the place of resettlement. Conclusion. Strength of attachment to the countryside and to other people, personal characteristics, contextual aspects and the way in which the bond was torn allow the understanding of the possibilities and limits for life reconstruction. However, some losses remain as wounds impossible to heal, generally those associated with horror-related experiences.
Escopo. Foram analisados os significados atribuídos às experiências de perdas múltiplas e a elaboração do dolo em pessoas refugiadas que habitam atualmente na cidade de Medellín (Colômbia). Metodologia. Estudo descritivo com enfoque fenomenológico-hermenêutico. Participaram voluntariamente 18 pessoas em situação de deslocamento forçado que reconstruíram sua experiência em entrevistas semiestruturadas. A análise dos dados foi realizada mediante o programa Atlas Ti. Resultados. O deslocamento forçado causa múltiplas perdas físicas e simbólicas. A dor, a incerteza, a desconfiança, o medo, as expressões somáticas e as condutas de isolamento são respostas comuns frente a esta experiência e quadra os significados construídos ao redor dela. O dolo segue um processo de elaboração parcial de acordo com as características pessoais, o apoio social e os recursos simbólicos e econômicos disponíveis nos lugares de reassentamento. Conclusão. A força do apego ao campo e aos outros, as características pessoais, os aspetos contextuais e a forma em que o vínculo é quebrado permite compreender as possibilidades e os limites para a reconstrução da vida. Algumas perdas, geralmente aquelas associadas com experiências de horror, permanecem para os afetados como feridas impossíveis de sanar.
Assuntos
Humanos , Pesar , Migração Interna , ViolênciaRESUMO
BACKGROUND: Since 1999, in Mexico we have been using a regimen to conduct allografts that involves non-myeloablative conditioning and peripheral blood stem cells (PBSC) and have introduced some changes with the main goal of decreasing the cost of the procedure. MATERIALS AND METHODS: We analysed the salient apheresis features of a group of 175 allogeneic peripheral blood stem cell transplants conducted in two institutions in a 7-year period. The grafts were conducted using the "Mexican" non-myelo ablative conditioning regimen employing oral busulphan, i.v. cyclophosphamide and i.v. fludarabine. In all instances, the apheresis machine employed was the Baxter CS3000 Plus and donors were mobilised with filgrastim. The apheresis procedures were performed on days 0, +1 and +2, the end-point of collection being 5,000 mL of blood/m2 in each procedure. Three apheresis sessions were planned but the number was adjusted according to the cell yield. RESULTS: The final number of allografted CD34 cells ranged between 0.5 and 25.4 x 10(6)/Kg of the recipient's body weight (median, 5.2 x 10(6)/Kg). One to three apheresis procedures were needed to obtain a product containing more than 0.5 x 10(6) CD34 cells/Kg of the recipient, the median being two procedures; in 72 cases (41%) a single apheresis procedure was sufficient to obtain the target number of CD34 cells. The volumes of apheresis ranged between 50 and 600 mL (median, 400 mL). CONCLUSIONS: Since the median cost of each apheresis procedure is 900 USD, the fact that two apheresis procedures was spared in 72 cases and one apheresis was spared in another 65 cases, led to a total saving of approximately 188,100 USD. It can be concluded that, in many cases, allogeneic transplants can be completed with a single apheresis session and that there are considerable financial benefits from this practice.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Remoção de Componentes Sanguíneos/métodos , Doadores de Sangue , Ablação por Cateter , Neoplasias Hematológicas/terapia , Anemia Aplástica/terapia , Remoção de Componentes Sanguíneos/economia , Bussulfano/administração & dosagem , Análise Custo-Benefício , Ciclofosfamida/administração & dosagem , Filgrastim , Fator Estimulador de Colônias de Granulócitos/uso terapêutico , Neoplasias Hematológicas/economia , Neoplasias Hematológicas/mortalidade , Transplante de Células-Tronco Hematopoéticas/métodos , Humanos , Leucemia Mielogênica Crônica BCR-ABL Positiva/terapia , México , Leucemia-Linfoma Linfoblástico de Células Precursoras/terapia , Proteínas Recombinantes , Estudos Retrospectivos , Análise de Sobrevida , Condicionamento Pré-Transplante , Transplante Homólogo/métodos , Vidarabina/administração & dosagem , Vidarabina/análogos & derivadosRESUMO
Objetivos: Determinar la histología vegetal y la influencia del extracto etanólico de la planta entera de Bidens pilosa L. sobre el cáncer de colón inducido en ratas. Diseño: Estudio experimental. Lugar: Facultades de Medicina, de Farmacia y Bioquímica y de Ciencias Biológicas, Universidad Nacional Mayor de San Marcos, Lima, Perú. Material biológico: Ratas Holzmann. Intervenciones: Se agrupó 48 ratas Holtzmann, de 2 meses de edad, con pesos 100 g a 130 g, en seis grupos de ocho cada uno, y se indujo cáncer de colon con 1,2-dimetilhidrazina. Los grupos estuvieron constituidos por control normal, grupo con patología y grupos con patología y tratamientos. Principales medidas de resultados: Nivel de óxido nítrico, estrés oxidativo y cambios en el patrón celular del colon. Resultados: Se encontró incremento de los niveles de óxido nítrico y lipoperoxidación en los animales con 1,2-dimetilhidracina (DMH) y disminución en los que recibieron el tóxico más extracto de la planta. Al estudio histopatológico, con la DMH se evidenció desorganización celular, adenocarcinoma indiferenciado e invasivo; en tanto que, con los tratamientos se observó citoprotección, no dependiente de la dosis, siendo mayor a 50 mg/kg. Los hallazgos probablemente se expliquen porque los flavonoides y los compuestos fenólicos presentes en el extracto cumplen un rol importante en la inhibición del estrés oxidativo y también como anticancerígenos, inhibiendo el crecimiento de tumores. Se encontró detalles histológicos que servirían como caracteres diagnósticos, ayudando a verificar la identidad de la especie vegetal en polvo. Conclusiones: En condiciones experimentales, el extracto etanólico de la planta entera de Bidens pilosa L. presentó efecto quimioprotector sobre el cáncer de colon.
Objectives: To determine the influence of Bidens pilosa L. whole plant ethanolic extract on colon cancer induced in rats. Design: Experimental study. Setting: Faculties of Medicine, Pharmacy and Biochemistry and Biologic Sciences, Universidad Nacional Mayor de San Marcos, Lima, Peru. Biologic material: Holzmann rats. Interventions: Forty eight 2 months 100 g to 130 g Holtzmann rats were separated in six groups of eight each and 1,2-dimethylhidrazine induction of colon cancer was performed. Groups were normal control, group with pathology and groups with pathology and treatments. Main outcome measures: Nitric oxide levels, oxidative stress markers and colon cellular pattern modifications. Results: There was increment of nitric oxide levels and lipoperoxidation in the 1,2-dimethylhidrazine (DMH) animals, and decrease in those receiving both the toxic and the plant extract. Histopathology revealed cellular disorganization, undifferentiated and invasive adenocarcinoma with DMH; non-dose dependent cytoprotection was evident with treatments, especially with 50 mg/kg. Findings may be due to whole extract flavonoids and phenolic compounds contained in the whole extract that may play an important role in both oxidative stress and anticarcinogenic tumor growth inhibition. Histology details could be diagnostic characteristics useful to verify the vegetable powdered species identity. Conclusions: Under experimental conditions the ethanolic extract of Bidens pilosa L. whole plant presented chemoprotective effect on colon cancer.