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1.
Sci Total Environ ; 879: 163103, 2023 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-36972881

RESUMO

Methods targeting anionic per- and polyfluoroalkyl substances (PFAS) in aquatic biota are well established, but commonly overlook many PFAS classes present in aqueous film-forming foams (AFFFs). Here, we developed an analytical method for the expanded analysis of negative and positive ion mode PFAS in fish tissues. Eight variations of extraction solvents and clean-up protocols were first tested to recover 70 AFFF-derived PFAS from the fish matrix. Anionic, zwitterionic, and cationic PFAS displayed the best responses with methanol-based ultrasonication methods. The response of long-chain PFAS was improved for extracts submitted to graphite filtration alone compared with those involving solid-phase extraction. The validation included an assessment of linearity, absolute recovery, matrix effects, accuracy, intraday/interday precision, and trueness. The method was applied to a set of freshwater fish samples collected in 2020 in the immediate vicinity (creek, n = 15) and downstream (river, n = 15) of an active fire-training area at an international civilian airport in Ontario, Canada. While zwitterionic fluorotelomer betaines were major components of the subsurface AFFF source zone, they were rarely detected in fish, suggesting limited bioaccumulation potential. PFOS largely dominated the PFAS profile, with record-high concentrations in brook sticklebacks (Culaea inconstans) from the creek (16000-110,000 ng/g wet weight whole-body). These levels exceeded the Canadian Federal Environmental Quality Guidelines (FEQG) for PFOS pertaining to the Federal Fish Tissue Guideline (FFTG) for fish protection and Federal Wildlife Diet Guidelines (FWiDG) for the protection of mammalian and avian consumers of aquatic biota. Perfluorohexane sulfonamide and 6:2 fluorotelomer sulfonate were among the precursors detected at the highest levels (maximum of ∼340 ng/g and ∼1100 ng/g, respectively), likely reflecting extensive degradation and/or biotransformation of C6 precursors originally present in AFFF formulations.


Assuntos
Fluorocarbonos , Smegmamorpha , Poluentes Químicos da Água , Animais , Aeroportos , Poluentes Químicos da Água/análise , Fluorocarbonos/análise , Ontário , Água/análise , Peixes/metabolismo , Smegmamorpha/metabolismo , Mamíferos/metabolismo
2.
Chemosphere ; 309(Pt 1): 136769, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36209849

RESUMO

The widespread distribution of contaminants of emerging concern (CECs) is a major concern due to their potential effects on human health and the environment. The insufficient sewage treatment plant infrastructures is a global problem most accentuated in less developed countries and results in the discharge of CECs to water bodies. Pacu (Piaractus mesopotamicus) is a ray-finned freshwater fish species native to the Paraná basin. It is also the most produced aquaculture fish species in Argentina since 2012. Though uninvestigated to date, the occurrence of CECs in pacu may be of high relevance due to production volumes and relevance to human exposure through fish consumption. In this study, we applied a high-resolution mass spectrometry screening method to qualitatively analyze over 100 CECs in pacu. Four extraction/cleanup methods were tested on pooled pacu fillet, including solid-phase extraction and QuEChERS. The method that produced the highest number of detections was selected for further analysis of pacu purchased in supermarkets and fish markets in Argentina between 2017 and 2020. Residues of pesticides, antibiotics, pharmaceuticals, personal care products, plasticizers, sweeteners, drug metabolites, stimulants, and illegal drugs were detected in the samples. A total of 38 CECs were detected, ranging between 24 and 35 CECs per individual sample. 100% of the samples had positive detections of caffeine, 1,7-dimethylxanthine, xanthine, benzoylecgonine, methylparaben, ethylparaben, bis(2-ethylhexyl) phthalate (DEHP), metolachlor, carbendazim, salicylic acid, 2,4-D, saccharin, cyclamate, and dodecanedioic acid. Mappings generated with correspondence analysis were used to explore similarities/dissimilarities among the detected compounds. To our knowledge this is the first report of saccharin, cyclamate, 2,4 - D, carbendazim, metolachlor, ethylparaben, propylparben, bisphenol A, DEHP, and benzotriazole in fish from Argentina, and the first report on the presence of lisinopril, metropolol acid and dodecanedioic acid in fish worldwide.


Assuntos
Drogas Ilícitas , Praguicidas , Poluentes Químicos da Água , Animais , Ácido 2,4-Diclorofenoxiacético , Antibacterianos/análise , Argentina , Cafeína/análise , Ciclamatos/análise , Dietilexilftalato , Monitoramento Ambiental , Drogas Ilícitas/análise , Lisinopril , Praguicidas/análise , Plastificantes/análise , Sacarina/análise , Ácido Salicílico/análise , Esgotos/análise , Edulcorantes/análise , Poluentes Químicos da Água/análise
3.
Toxins (Basel) ; 14(4)2022 03 31.
Artigo em Inglês | MEDLINE | ID: mdl-35448860

RESUMO

The neurotoxic alkaloid ß-N-methyl-amino-l-alanine (BMAA) and related isomers, including N-(2-aminoethyl glycine) (AEG), ß-amino-N-methyl alanine (BAMA), and 2,4-diaminobutyric acid (DAB), have been reported previously in cyanobacterial samples. However, there are conflicting reports regarding their occurrence in surface waters. In this study, we evaluated the impact of amending lake water samples with trichloroacetic acid (0.1 M TCA) on the detection of BMAA isomers, compared with pre-existing protocols. A sensitive instrumental method was enlisted for the survey, with limits of detection in the range of 5−10 ng L−1. Higher detection rates and significantly greater levels (paired Wilcoxon's signed-rank tests, p < 0.001) of BMAA isomers were observed in TCA-amended samples (method B) compared to samples without TCA (method A). The overall range of B/A ratios was 0.67−8.25 for AEG (up to +725%) and 0.69−15.5 for DAB (up to +1450%), with absolute concentration increases in TCA-amended samples of up to +15,000 ng L−1 for AEG and +650 ng L−1 for DAB. We also documented the trends in the occurrence of BMAA isomers for a large breadth of field-collected lakes from Brazil, Canada, France, Mexico, and the United Kingdom. Data gathered during this overarching campaign (overall, n = 390 within 45 lake sampling sites) indicated frequent detections of AEG and DAB isomers, with detection rates of 30% and 43% and maximum levels of 19,000 ng L−1 and 1100 ng L−1, respectively. In contrast, BAMA was found in less than 8% of the water samples, and BMAA was not found in any sample. These results support the analyses of free-living cyanobacteria, wherein BMAA was often reported at concentrations of 2−4 orders of magnitude lower than AEG and DAB. Seasonal measurements conducted at two bloom-impacted lakes indicated limited correlations of BMAA isomers with total microcystins or chlorophyll-a, which deserves further investigation.


Assuntos
Diamino Aminoácidos , Cianobactérias , Alanina , Diamino Aminoácidos/análise , Brasil , Lagos/microbiologia , México , Neurotoxinas/análise , Água/análise
4.
Neuropsychobiology ; 81(4): 271-285, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35093946

RESUMO

INTRODUCTION: Major depressive disorder (MDD) is a prevalent condition which has a well-known association with ischemic cardiomyopathy, probably explained by an inflammatory mediator mechanism. Statins, besides reducing cholesterol production, have pleiotropic effects including anti-inflammatory activity. The goal was to evaluate the effect of statins as an addition to standard therapy on mood status, brain perfusion, and neurocognitive performance in MDD. METHODS: We studied 20 MDD patients with brain single-photon emission tomography and Cambridge Neuropsychological Test Automated Battery (CANTAB), half randomized to 10 mg of Rosuvastatin or placebo, in addition to selective serotonin reuptake inhibitors (SSRIs) therapy and being reevaluated 3 months later. The images were compared using Statistical Parametric Mapping; clinical scores (Hamilton Depression Score with 17 items and Beck's Depression Inventory) as well as neurocognitive parameters were applied as covariances (CoV) to estimate regional cerebral blood flow (rCBF) changes with both therapies. RESULTS: Clinical scores decreased in both groups (p = 0.0001); Beck's presented a larger decrease with statins. We observed significantly rCBF changes expressed as significant larger clusters of voxels (p < 0.05) in the pre/subgenual anterior cingulate plus orbitofrontal cortex and a small area in the posterior cingulate gyrus in the statins group, whereas it was not observed with placebo, when using clinical scores as CoV. A similar pattern of rCBF changes was present with emotions recognition, attentional, paired associates learning, spatial planning, and working memory tasks. CONCLUSION: Short-term use of low-dose statins in MDD patients under SSRIs results in important rCBF changes in key mood associated areas to improvement in neurocognitive performance. These findings, even though demonstrated in a small sample, could open a new therapeutic tool in the comprehensive management of this disorder.


Assuntos
Transtorno Depressivo Maior , Inibidores de Hidroximetilglutaril-CoA Redutases , Encéfalo/diagnóstico por imagem , Circulação Cerebrovascular/fisiologia , Transtorno Depressivo Maior/diagnóstico por imagem , Transtorno Depressivo Maior/tratamento farmacológico , Giro do Cíngulo , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/farmacologia , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Perfusão , Inibidores Seletivos de Recaptação de Serotonina/farmacologia , Inibidores Seletivos de Recaptação de Serotonina/uso terapêutico , Tomografia Computadorizada de Emissão de Fóton Único/métodos
5.
J Orthop ; 22: 203-206, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32425418

RESUMO

OBJECTIVE: Our purpose was to evaluate the validity and reliability of the laxity with the GNRB arthrometer in subjects with anterior cruciate ligament injury. MATERIAL AND METHOD: A diagnostic study was performed by three operators using the Genourob arthrometer, measuring the displacement of the anterior cruciate ligament. The concordance was assessed by the intraclass correlation coefficient mixed effects model, Lin correlation coefficient and graphic method from Bland-Altman. Using the anterior cruciate ligament tear as a dependent variable and the Genourob measurement as an independent variable, a logistic regression was determined. RESULTS: Obtaining the complete information of 157 knees. The measurements with the Genourob arthrometer distributed symmetrically, with mean ± standard deviation of knees with anterior cruciate ligament injury: 5.64 ± 1.72 and knees without anterior cruciate ligament injury: 3.29 ± 1.72. The ICCs as well as the LCCs were equal to or greater than 0.99. The BA showed discrepancy for a pair of observations no greater than 7.64%. The odds ratio of the knee displacement measurement for the presence of anterior cruciate ligament injury was 4.04 (95% CI: 2.59-6.32; p-value < .01) with a ROC area of 0.863 (95% CI: 0.789-0.9456). The cut-off point of the anteroposterior knee displacement located at 6.8 mm determined a sensitivity of 74.4% and specificity of 93.8%, with a Youden Index = 0.67. CONCLUSION: The Genourob arthrometer is reliable and valid to establish where laxity values correlate with total thickness tears of the anterior cruciate ligament.

6.
Urol Case Rep ; 10: 4-5, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27800297

RESUMO

There are several benign prostatic pathologies that can clinically mimic a prostate adenocarcinoma. Xanthogranulomatous prostatitis is a benign inflammatory condition of the prostate and a rare entity. A 47-year old male, with 3 years of lower urinary tract symptoms, with a palpable hypogastric tumor, digital rectal examination: solid prostate, of approximately 60 g. Initial PSA was 0.90 ng/mL. He underwent surgical excision of the lower abdominal nodule and prostatectomy. Histopathology showed xanthogranulomatous prostatitis, without malignancy. Xanthogranulomatous prostatitis is an extremely rare entity that can simulate prostate adenocarcinoma, therefore having a correct histopathological diagnosis is essential.

7.
Learn Mem ; 20(8): 446-52, 2013 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-23869027

RESUMO

Active avoidance (AA) is an important paradigm for studying mechanisms of aversive instrumental learning, pathological anxiety, and active coping. Unfortunately, AA neurocircuits are poorly understood, partly because behavior is highly variable and reflects a competition between Pavlovian reactions and instrumental actions. Here we exploited the behavioral differences between good and poor avoiders to elucidate the AA neurocircuit. Rats received Sidman AA training and expression of the activity-dependent immediate-early gene c-fos was measured after a shock-free AA test. Six brain regions with known or putative roles in AA were evaluated: amygdala, periaqueductal gray, nucleus accumbens, dorsal striatum, prefrontal cortex (PFC), and hippocampus. Good avoiders showed little Pavlovian freezing and high AA rates at test, the opposite of poor avoiders. Although c-Fos activation was observed throughout the brain, differential activation was found only in subregions of amygdala and PFC. Interestingly, c-Fos correlated with avoidance and freezing in only five of 20 distinct areas evaluated: lateral amygdala, central amygdala, medial amygdala, basal amygdala, and infralimbic PFC. Thus, activity in specific amygdala-PFC circuits likely mediates the competition between instrumental actions and Pavlovian reactions after AA training. Individual differences in AA behavior, long considered a nuisance by researchers, may be the key to elucidating the AA neurocircuit and understanding pathological response profiles.


Assuntos
Tonsila do Cerebelo/fisiologia , Aprendizagem da Esquiva/fisiologia , Córtex Pré-Frontal/fisiologia , Proteínas Proto-Oncogênicas c-fos/metabolismo , Tonsila do Cerebelo/metabolismo , Animais , Masculino , Córtex Pré-Frontal/metabolismo , Ratos , Ratos Sprague-Dawley
8.
Cir Cir ; 77(4): 275-8; 257-9, 2009.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-19919788

RESUMO

BACKGROUND: Patients with cold thyroid nodules without ultrasound malignant suspicion and with benign/undetermined cytology may be subjected to follow-up surveillance. 99mTc-tetrofosmin scan (99mTc-TS) may identify patients where this observation can be performed with more certainty. Absence of uptake never occurs in carcinoma patients. Our objective was to determine the 99mTc-TS negative predictive value (NPV) in patients with cold thyroid nodules. METHODS: An evaluation with 99mTc-TS was conducted prior to surgery in patients with thyroid gland tumor who were candidates for surgery. All patients underwent thyroidectomy according to histology; NPV and test sensitivity were evaluated when compared with the histopathological result. Then, 296-370 MBq (8-10 mCi) of 99mTc-tetrofosmin was administered, and scan images were evaluated after 120 min. Scan result was reported as a) with increased metabolic activity (IMA) or b) without increased metabolic activity (WIMA). RESULTS: Included in the study were 86 consecutive patients. In 60 patients the scan showed IMA, 20/60 (33%) with carcinoma, 67% with benign nodule. In 26 (30.2%) the scan was WIMA. In this group, 3/26 (11.5%) had carcinoma and (88.4%) had a benign neoplasia. Sensitivity = 91.43 (95% CI = 80.73-100), specificity = 45.10 (95% CI = 30.46-59.73), positive predictive value = 53.33 (95% CI = 39.8-66.79) and NPV = 88.46 (95% CI 74.26-100). Negative probability ratio = 0.19. CONCLUSIONS: IMA-99mTc-TS is less specific in thyroid cancer; nevertheless, in WIMA patients the possibility of carcinoma is 13%. Most patients (70%) showed IMA, 33% with carcinoma. WIMA-NPV = 30%. 99mTc-TS may be useful in the therapeutic decision of patients with thyroid nodule with concerns about surgery. Its usefulness lies in the NPV.


Assuntos
Compostos Organofosforados , Compostos de Organotecnécio , Compostos Radiofarmacêuticos , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/patologia , Humanos , Valor Preditivo dos Testes , Cintilografia
9.
Cir. & cir ; Cir. & cir;77(4): 275-278, jul.-ago. 2009.
Artigo em Espanhol | LILACS | ID: lil-566478

RESUMO

Introducción: Los pacientes con nódulos tiroideos hipocaptantes sin sospecha ultrasonográfica y con citología benigna o indeterminada pueden ser vigilados. El gammagrama con Tc- 99m-tetrofosmín (Tc-99m-TS) identifica pacientes en los que la vigilancia es más segura. La ausencia de captación nunca ocurre en pacientes con carcinoma. El objetivo de este estudio fue conocer el valor predictivo negativo del Tc-99m-TS en pacientes con nódulo tiroideo. Material y métodos: Evaluación preoperatoria con Tc-99m-TS de pacientes con nódulo tiroideo candidatos a cirugía. Tiroidectomía de acuerdo con el diagnóstico en todos. Evaluación de valor predictivo negativo y sensibilidad al comparar con el resultado histopatológico. Se administraron 296-370 MBq (8-10 mCi) de Tc-99m-TS; evaluación de imágenes a los 120 minutos. Resultado reportado con actividad metabólica aumentada (AMA) o sin actividad metabólica aumentada (SAMA). Resultados: Se incluyeron 86 pacientes consecutivos. Sesenta (69.7 %) tuvieron AMA, 20/60 con carcinoma (33 %), en 67 % el diagnóstico fue de nódulo benigno. En 26 (30.2 %) SAMA, 11.5 % tuvo carcinoma y 88.4 % neoplasia benigna. Sensibilidad de 91.43 % (IC 95 % = 80.73-100 %), especificidad de 45.10 % (IC 95 % = 30.46-59.73), valor predictivo positivo de 53.33 % (IC 95 % = 39.8-66.79), valor predictivo negativo de 88.46 % (IC 95 % = 74.26-100). Razón de verosimilitud negativa = 0.19. Conclusiones: Tc-99m-TS con AMA es poco específico en cáncer tiroideo; en pacientes SAMA 13 % tiene carcinoma. La mayoría de los pacientes (70 %) mostró AMA, 33 % con carcinoma. Valor predictivo negativo en grupo SAMA = 88 %. Tc-99m-TS podría ser útil en la decisión terapéutica de pacientes con nódulo tiroideo en los que existe duda de cirugía; su utilidad radica en el valor predictivo negativo.


BACKGROUND: Patients with cold thyroid nodules without ultrasound malignant suspicion and with benign/undetermined cytology may be subjected to follow-up surveillance. 99mTc-tetrofosmin scan (99mTc-TS) may identify patients where this observation can be performed with more certainty. Absence of uptake never occurs in carcinoma patients. Our objective was to determine the 99mTc-TS negative predictive value (NPV) in patients with cold thyroid nodules. METHODS: An evaluation with 99mTc-TS was conducted prior to surgery in patients with thyroid gland tumor who were candidates for surgery. All patients underwent thyroidectomy according to histology; NPV and test sensitivity were evaluated when compared with the histopathological result. Then, 296-370 MBq (8-10 mCi) of 99mTc-tetrofosmin was administered, and scan images were evaluated after 120 min. Scan result was reported as a) with increased metabolic activity (IMA) or b) without increased metabolic activity (WIMA). RESULTS: Included in the study were 86 consecutive patients. In 60 patients the scan showed IMA, 20/60 (33%) with carcinoma, 67% with benign nodule. In 26 (30.2%) the scan was WIMA. In this group, 3/26 (11.5%) had carcinoma and (88.4%) had a benign neoplasia. Sensitivity = 91.43 (95% CI = 80.73-100), specificity = 45.10 (95% CI = 30.46-59.73), positive predictive value = 53.33 (95% CI = 39.8-66.79) and NPV = 88.46 (95% CI 74.26-100). Negative probability ratio = 0.19. CONCLUSIONS: IMA-99mTc-TS is less specific in thyroid cancer; nevertheless, in WIMA patients the possibility of carcinoma is 13%. Most patients (70%) showed IMA, 33% with carcinoma. WIMA-NPV = 30%. 99mTc-TS may be useful in the therapeutic decision of patients with thyroid nodule with concerns about surgery. Its usefulness lies in the NPV.


Assuntos
Humanos , Compostos Organofosforados , Compostos Radiofarmacêuticos , Compostos de Organotecnécio , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide , Valor Preditivo dos Testes
10.
Cir Cir ; 76(3): 213-7, 2008.
Artigo em Espanhol | MEDLINE | ID: mdl-18647554

RESUMO

BACKGROUND: We undertook this study to evaluate the results obtained with conservation therapy of the larynx in patients with laryngopharyngeal epidermoid carcinoma. METHODS: Patients with stages I and II epidermoid cancer of the larynx and pharynx were included. All patients were evaluated endoscopically, functionally, and with cervical tomography. Results of the procedures were evaluated on the basis of oncological control and laryngeal function (voice, swallowing and ventilation). RESULTS: There were 41 male patients with a median age of 55 years. In 32 patients, surgery was the initial treatment and in nine patients as rescue treatment after radiotherapy. In 58.5% the location was glottic, in 22% supraglottic, in 12% glotto-supraglottic and in 7% vallecular and hypopharynx. Subtotal laryngectomy was performed with cricohyoidepiglottopexy in 18 patients, frontolateral in 11, supraglottic in 5, subglottic-epiglottectomy in 3, hemipharyngolaryngectomy in 3, and in one hemiglottectomy. The time until decannulation and removal of nasogastric catheter depended on the type of surgery. One patient (2%) had to be subjected to a rescue laryngectomy due to constant aspiration. This patient demonstrated residual tumor in the sample. Nine patients had some type of complication, the most frequent being wound infection (7.3%). One patient died postoperatively due to sepsis (2.4%), and another patient died due to systemic causes 4 months after the intervention. Median follow-up time is 25 months and no patient has presented tumor recurrence. CONCLUSIONS: Voice conservation surgery is an alternative to mutilation of the larynx in patients with locally advanced neoplasms of the larynx with a high risk of recurrence if treated with radiotherapy.


Assuntos
Carcinoma de Células Escamosas/cirurgia , Neoplasias Laríngeas/cirurgia , Laringectomia/métodos , Neoplasias Primárias Múltiplas/cirurgia , Neoplasias Faríngeas/cirurgia , Faringectomia/métodos , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
11.
Cir. & cir ; Cir. & cir;76(3): 213-217, mayo-jun. 2008. tab
Artigo em Espanhol | LILACS | ID: lil-567106

RESUMO

BACKGROUND: We undertook this study to evaluate the results obtained with conservation therapy of the larynx in patients with laryngopharyngeal epidermoid carcinoma. METHODS: Patients with stages I and II epidermoid cancer of the larynx and pharynx were included. All patients were evaluated endoscopically, functionally, and with cervical tomography. Results of the procedures were evaluated on the basis of oncological control and laryngeal function (voice, swallowing and ventilation). RESULTS: There were 41 male patients with a median age of 55 years. In 32 patients, surgery was the initial treatment and in nine patients as rescue treatment after radiotherapy. In 58.5% the location was glottic, in 22% supraglottic, in 12% glotto-supraglottic and in 7% vallecular and hypopharynx. Subtotal laryngectomy was performed with cricohyoidepiglottopexy in 18 patients, frontolateral in 11, supraglottic in 5, subglottic-epiglottectomy in 3, hemipharyngolaryngectomy in 3, and in one hemiglottectomy. The time until decannulation and removal of nasogastric catheter depended on the type of surgery. One patient (2%) had to be subjected to a rescue laryngectomy due to constant aspiration. This patient demonstrated residual tumor in the sample. Nine patients had some type of complication, the most frequent being wound infection (7.3%). One patient died postoperatively due to sepsis (2.4%), and another patient died due to systemic causes 4 months after the intervention. Median follow-up time is 25 months and no patient has presented tumor recurrence. CONCLUSIONS: Voice conservation surgery is an alternative to mutilation of the larynx in patients with locally advanced neoplasms of the larynx with a high risk of recurrence if treated with radiotherapy.


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/cirurgia , Faringectomia/métodos , Laringectomia/métodos , Neoplasias Faríngeas/cirurgia , Neoplasias Laríngeas/cirurgia , Neoplasias Primárias Múltiplas/cirurgia
12.
Cir Cir ; 75(3): 151-5, 2007.
Artigo em Espanhol | MEDLINE | ID: mdl-17659164

RESUMO

BACKGROUND: Head and neck squamous cell carcinoma (HNSCC) is the 6th most common cancer worldwide. In 2005, 400,000 cases of HNSCC were diagnosed worldwide. The most frequently affected site is the oral cavity. Alcohol/tobacco consumption is the most important risk factor for this neoplasia; nevertheless, since 1983 it has been suggested that human papilloma viruses (HPV) have a role in HNSCC, mainly in the oropharynx (level 1 evidence). We undertook this study to determine HPV prevalence and types in patients with HNSCC. METHODS: Presence of HPV was determined by polymerase chain reaction and staged by in situ hybridization. We analyzed stage, tumor site of origin, sexual practices, and alcohol/tobacco consumption. Fisher's exact test and Student's t-test were used for statistical analysis. We performed a multiple regression analysis for adjustment of variables. RESULTS: There were 118 patients were HPV positive and oropharyngeal and laryngeal cancer patients were the most frequently affected (55% and 50%, respectively). HPV-16 was most frequently isolated (70%). Laryngeal cancer patients suffered the highest ratio of HPV-16 infection (68.7%). Factors associated with HPV (univariate analysis) were age >50 years, tobacco/alcohol consumption and male gender. In multivariate analysis, none of the variables showed importance (p >0.5); HPV infection was more frequent in patients with history of alcohol/tobacco consumption (p = 0.6). CONCLUSIONS: There was HPV presence in 42% of HNSCC patients, HPV-16 in 70%, with the oropharynx and larynx being the most affected sites. No variables are associated with the virus presence. HPV is a co-factor in HNSCC etiology.


Assuntos
Neoplasias de Cabeça e Pescoço/virologia , Papillomaviridae/isolamento & purificação , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
14.
Behav Neurosci ; 120(5): 1093-102, 2006 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-17014260

RESUMO

The involvement of neurotensin (NT) within the nucleus accumbens core (NAC) in behavior has been sparsely investigated. Moreover, little is known of what role NT within the ventral striatum has on spatial learning. The present study investigated whether NT receptors in the NAC are implicated in learning of spatial information. Male Long-Evans rats were trained on a food search spatial learning task. Rats were microinfused with either NT antagonist SR 48692 (50 nM/0.5 =L) or saline in the NAC before each training session. Rats treated with SR 48692 made more reference and working memory errors during the acquisition of spatial learning than did rats infused with saline. These results suggest that NT receptors contribute to NAC-mediated spatial learning.


Assuntos
Comportamento Apetitivo/efeitos dos fármacos , Neurotensina/antagonistas & inibidores , Núcleo Accumbens/efeitos dos fármacos , Orientação/efeitos dos fármacos , Pirazóis/farmacologia , Quinolinas/farmacologia , Animais , Ingestão de Alimentos/efeitos dos fármacos , Masculino , Memória de Curto Prazo/efeitos dos fármacos , Atividade Motora/efeitos dos fármacos , Ratos , Ratos Long-Evans , Receptores de Neurotensina/antagonistas & inibidores
15.
Oral Oncol ; 41(9): 947-52, 2005 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-16051515

RESUMO

In patients with oral cavity epidermoid cancer without palpable nodes, the standard cervical treatment is supraomohyoid dissection; nevertheless, lymphatic mapping with sentinel node (SN) biopsy has been useful and allows the identification of a group of patients where neck dissection may be prevented. The objective of this study was to examine which factors diagnose the possibility of metastasis in SN. A non-randomized prospective study was performed during a two year period and included patients with T1-2, N0 oral cavity cancer >4 mm thick, SN was identified by blue dye and Rhenium colloid. All patients underwent pre-operatory lymphogammagraphy and elective-selective neck dissection. Age, gender, tumor site, T, tumor thickness and number of sentinel nodes found were evaluated. In 48 patients, at least one sentinel node was found, 2 per patient on average. 10.4% showed drainage outside the supraomohyoid region, 13/48 had nodular metastasis, 4 with negative SN(8.3%). T, location, thickness and number of SN are related to non-SN metastasis. Identification of 3SN or more was related to the possibility of SN metastasis p=0 (RR 10.1, I. C. 95% 1.1 91.2). The combined technique (dye-colloid) offers a high index of success in the identification of SN in patients with oral cavity cancer, while lymphogammagraphy identifies patients with anatomically unexpected drainage. Patients with T1 less than 2cm, not located on the tongue with thickness <5 mm and more than 2 SN were less likely to have metastasis in non-sentinel nodes. The identification of at least 3 sentinel nodes decreases the possibility of identifying patients with hidden metastasis (p=0.04).


Assuntos
Carcinoma de Células Escamosas/secundário , Neoplasias Bucais/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Linfonodos/diagnóstico por imagem , Metástase Linfática/diagnóstico , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Cintilografia , Sensibilidade e Especificidade , Biópsia de Linfonodo Sentinela/métodos
16.
Cir Cir ; 73(1): 3-6, 2005.
Artigo em Espanhol | MEDLINE | ID: mdl-15888262

RESUMO

INTRODUCTION: In patients with laryngeal invasive epidermoid carcinoma who are candidates for total laryngectomy, it is recommended to resect en bloc at least half of the thyroid gland on the same side as the laryngeal tumor with the objective of decreasing local recurrence associated with thyroid infiltration. Nevertheless, in the histopathologic analysis of the specimen, a minority of thyroid glands show tumor infiltration. The fact that in these patients even partial thyroid resection is associated with hypothyroidism increased by postoperative radiotherapy is well known. The study was undertaken to determine the frequency of thyroid gland invasion in patients who have undergone total laryngectomy due to laryngeal cancer and its associated factors. MATERIAL AND METHODS: We evaluated the histological results of glands resected en bloc with laryngectomy in patients who underwent total laryngectomy due to laryngeal cancer; the clinical stage was compared to the laryngeal subsite tumor origin. The glandular histological condition was compared to the local recurrence presence (peristomal). RESULTS: Ninety two patients were included, 11 (12%) showed glandular infiltration due to epidermoid carcinoma, all with tumors clinically typified as T3 and T4, 8/11 were transglottic and only 3 (27%) showed subglottic invasion. During follow-up (5-year mean) 17/92 showed peristomal recurrence (18%), only 3 (3%) showed thyroid invasion. Among patients with glandular invasion the peristoma recurrence rate was 27% (3/11). DISCUSSION: The best laryngeal cancer thyroid tumor invasion predictor is the evidence of extralaryngeal extension. Thyroid resection en bloc should not be routinely advised due to the low frequency of glandular infiltration.


Assuntos
Carcinoma de Células Escamosas/cirurgia , Neoplasias Laríngeas/cirurgia , Laringectomia , Glândula Tireoide/patologia , Tireoidectomia , Carcinoma de Células Escamosas/patologia , Humanos , Neoplasias Laríngeas/patologia , Laringectomia/normas , Invasividade Neoplásica , Estudos Retrospectivos , Tireoidectomia/normas
18.
Cir Cir ; 72(1): 11-3, 2004.
Artigo em Espanhol | MEDLINE | ID: mdl-15087046

RESUMO

INTRODUCTION: Standard care of patients with oral tongue-invasive squamous cell carcinoma in early stages is local resection and neck dissection. Traditionally, tumor resection was performed with hemiglossectomy (tongue resection in lingual long axis), which implied morbidity for deglutition and speech. Although surgical margins are sufficient, they are usually larger than necessary. OBJECTIVE: To know functional results and surgical margins in patients with T1-T2 oral tongue cancer submitted to transverse glossectomy (TG). MATERIAL AND METHODS: We analyzed charts of patients with T1-T2 oral tongue squamous cell carcinoma treated by TG during a 2-year period. We studied surgical margins, deglutition, speech intangibility, performance status and patient satisfaction. RESULTS: We included 20 patients: 12 women and eight men, with mean age of 45 years. Tumor-thickness mean was 8 mm; 19 patients showed free tumor margins in definitive histology study with mean of 1.8 cm three-dimensionally. In one patient, frozen sections were free-of-tumor, but definitive study showed a microscopic area of squamous cell carcinoma in surgical margin. All patients preserved > 50% of oral tongue and all showed lingual tip deviation and short tongue. None required nasogastric tube for feeding and speech was intelligible in all patients. CONCLUSIONS: TG provided sufficient surgical margin in all patients in this series without important morbidity and with good functional result; thus, TG is an alternative to classic vertical hemiglossectomy for patients in early stages of tongue mobile cancer.


Assuntos
Carcinoma de Células Escamosas/cirurgia , Glossectomia/métodos , Neoplasias da Língua/cirurgia , Humanos
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