RESUMO
INTRODUCTION: Osteoarthritis is a disabling pathology characterised by joint pain and stiffness. A prevalence of coxarthrosis of 7.4% is reported in our country. Total hip joint replacement is indicated in advanced stages, a procedure that is not free of complications, the most frequent being prosthetic dislocation, which can be prevented with dual mobility systems. The following study aims to determine the rate of complications and clinical outcomes in dual mobility systems in primary coxarthrosis. MATERIALS AND METHODS: A retrospective study included 120 cases in 114 patients diagnosed with grade III coxarthrosis, mean age was 62.43 years, with a mean follow-up of 4.5 years. Joint replacement was performed by Hardinge approach. All cases were assessed clinically using the Harris Hip Score (HHS) and radiologically to demonstrate mid-term results. RESULTS: The preoperative value on the HHS scale had a mean of 56.45, postoperative at one month 74.23; 6 months 85.40; 1 year 94.01 and at 5 years 94.84 points, representing a functional improvement of 17.78 postoperative month; 28.95 at 6 months postoperative; 37.56 at one year postoperative and 38.39 points at 5 years postoperative. A complication rate of 3.44%; 0.86% of complications were associated with the prosthetic components. CONCLUSION: The dual mobility system should be considered as a therapeutic option in primary hip joint replacement due to excellent functional results and low complication rates. EVIDENCE LEVEL: IV. Retrospective observational case series study.
RESUMO
The dogs' responses to training exercise are seldom monitored using physiological variables, and cardiac autonomic regulation (CAR) is a relevant determinant of endurance-training adaptation. There are studies in the literature establishing that regular exercise could interfere with CAR in dogs, measured by heart rate and vagal-derived indexes of heart-rate-variability (HRV). However, few studies were found using a prescribed training program based on the lactate threshold (LT) to determine HRV by a 24-h Holter analysis. The purpose of this study was to test whether an endurance-training program (ETP) guided individually by LT raises time-domain measures of HRV in healthy Beagle dogs. Twenty dogs were assigned to two groups: control (C) and trained (T). The dogs from group T underwent an incremental exercise test (IET) to determine their LT. Both LT and velocity corresponding to the LT (VLT) was determined by visual inspection. T group performed an eight-week endurance-training program consisting of treadmill runs set to 70-80% of the VLT. Next, dogs from the group T have submitted to IET again. The maximal velocities (Vmax) at which achieved by the trained dogs in both IETs were determined. The group S did not undergo IETs or ETP. HRV was determined by the 24-hour-Holter at rest, before and on the 2°, 4°, 6° and 8° training weeks. To examine the HR impact on HRV, standard HRV variables were normalized to prevailing HR. VLT and Vmax rose in group T, indicating an improvement of dogs' aerobic and anaerobic capacity. The normalized standard HRV indexes were relatively attenuated since these variables had a reduction in the degree of correlation concerning an average HR. The ETP resulted in decreased resting heart rate and increased time-domain indices, highlighting the log-transformed square root of the mean sum of the squared differences between R-R intervals (Ln rMSSD). The lactate-guided endurance-training program could lead to better parasympathetic cardiac modulation in Beagle dogs.
Assuntos
Frequência Cardíaca/fisiologia , Ácido Láctico/metabolismo , Condicionamento Físico Animal/métodos , Animais , Sistema Nervoso Autônomo/fisiologia , Cães , Eletrocardiografia Ambulatorial/métodos , Eletrocardiografia Ambulatorial/veterinária , Treino Aeróbico/métodos , Teste de Esforço , Feminino , Coração/fisiologia , Masculino , Resistência Física/fisiologia , Nervo Vago/fisiologiaRESUMO
BACKGROUND: Pancreatic cancer is one of the most aggressive types with high mortality in patients. Therefore, studies to discover new drugs based on cellular targets have been developed to treat this disease. Due to the importance of Cysteine Protease (CP) to several cellular processes in cancer cells, CP inhibitors have been studied as novel alternative approaches for pancreatic cancer therapy. OBJECTIVE: The cytostatic potential of new CP inhibitors derived from dipeptidyl nitriles is analyzed in vitro using pancreatic cancer (MIA PaCa-2) cells. METHODS: The cytotoxic and cytostatic activities were studied using MTT colorimetric assay in 2D and 3D cultures. Colony formation, migration in Boyden chamber and cell cycle analysis were applied to further study the cytostatic activity. The inhibition of cysteine proteases was evaluated with Z-FR-MCA selective substrate, and ROS evaluation was performed with DCFH-DA fluorophore. Permeability was investigated using HPLC-MS to obtain log kw. Combination therapy was also evaluated using the best compound with gemcitabine. RESULTS: The inhibition of intracellular CP activity by the compounds was confirmed, and the cytostatic effect was established with cell cycle retention in the G1 phase. CP inhibitors were able to reduce cell proliferation by 50% in the clonogenic assay, and the same result was achieved for the migration assay, without any cytotoxic effect. The Neq0554 inhibitor was also efficient to increase the gemcitabine potency in the combination therapy. Physicochemical properties using an artificial membrane model quantified 1.14 ≥ log Kw ≥ 0.75 for all inhibitors (also confirmed using HPLC-MS analysis) along with the identification of intra and extracellular metabolites. Finally, these dipeptidyl nitrile derivatives did not trigger the formation of reactive oxygen species, which is linked to genotoxicity. CONCLUSION: Altogether, these results provide a clear and favorable picture to develop CP inhibitors in pre-clinical assays.
Assuntos
Antineoplásicos/farmacologia , Carcinoma Ductal Pancreático/tratamento farmacológico , Inibidores de Cisteína Proteinase/farmacologia , Dipeptídeos/farmacologia , Nitrilas/farmacologia , Neoplasias Pancreáticas/tratamento farmacológico , Animais , Antineoplásicos/química , Células 3T3 BALB , Carcinoma Ductal Pancreático/metabolismo , Carcinoma Ductal Pancreático/patologia , Proliferação de Células/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Células Cultivadas , Físico-Química , Cisteína Proteases/metabolismo , Inibidores de Cisteína Proteinase/química , Dipeptídeos/química , Relação Dose-Resposta a Droga , Ensaios de Seleção de Medicamentos Antitumorais , Células Hep G2 , Humanos , Camundongos , Camundongos Endogâmicos BALB C , Nitrilas/química , Neoplasias Pancreáticas/metabolismo , Neoplasias Pancreáticas/patologia , Espécies Reativas de Oxigênio/análise , Relação Estrutura-AtividadeRESUMO
The need for optimal adherence to Highly Active Antiretroviral Therapy (HAART) is essential for successful treatment in Acquired immunedeficiency syndrome (aids). Objective: assess HAART's adherence and related socio-demographic, clinical and laboratory variables. Methods: crosssectional study. Sample calculation: 81 among 870 patients using HAART. Data collected between 14/09/2009 and 20/10/2009 at HIV/aids Outpatient Clinic of Federal University of Esp�rito Santo, Vit�ria - ES. Standardized forms and CEAT-VIH questionnaire translated and adapted to Brazilian language were used to access data and adherence, respectively. Considering the strict adherence outcomes ( 85% in the CEAT-VIH) and the presence or absence of possibly associated factor, univariate and multivariate analysis (binary logistic regression) were used and odds ratio (OR) was the association measure assessed. Results: strict adhesion was found in 42% of patients and mean adhesion was 81.1%. Medication use failure was reported by 76.5% of interviewed and main reasons were: forgetfulness (37%) and being away from home (30.9%). Strict adhesion was significantly associated with a higher number of completed years of study and a longer duration of undetectable viral load. Conclusion: despite an acceptable mean adhesion, strict adherence was poor.Better adherence was associated with a higher educational level and longer virological suppression.
Introdução: uma ótima adesão ao esquema antirretroviral de alta eficácia (HAART) é imprescindível para o sucesso terapêutico na síndrome da imunodeficiência adquirida humana (Aids). Objetivo: verificar a adesão ao HAART e identificar variáveis sociodemográficas, clínicas e laboratoriais relacionadas a esta. Métodos: estudo de inquérito simples com cálculo amostral de 81 pacientes dentre os 870 usando HAART no Serviço Especializado em HIV/Aids da Universidade Federal do Espírito Santo, Vitória ES. Os dados foram coletados entre 14/09/2009 a 20/10/2009. Formulário padronizado e a versão traduzida e adaptada à realidade brasileira do questionário CEAT-VIH foram utilizados para acessar os dados e a adesão, respectivamente. Os desfechos foram adesão estrita (≥ 85% no CEAT-VIH) ou não, e presença ou ausência de fator possivelmente associado, utilizaram-se análises uni e multivariada (regressão logística binária) e cálculo da Odds Ratio (OR) como medida de associação. Resultados: adesão estrita foi encontrada em 42% dos pacientes, com a média de adesão de 81,1%. Falha no uso da medicação ocorreu em 76,5% dos entrevistados, cujos principais motivos foram: esquecimento (37%) e estar longe de casa (30,9%). Adesão estrita esteve estatisticamente associada a um maior número de anos completos de estudo e a um maior tempo de carga viral indetectável. Conclusão: apesar de uma média de adesão aceitável, a adesão estrita foi insatisfatória. Melhor adesão esteve associada a um maior grau de escolaridade e maior tempo de supressão virológica.
Assuntos
Humanos , Adulto , Infecções Sexualmente Transmissíveis , Síndrome da Imunodeficiência Adquirida/terapia , Terapia Antirretroviral de Alta Atividade , Adesão à MedicaçãoRESUMO
En el Servicio de Otorrinolaringología del Hospital "Dr. Domingo Luciani", se reportan laringectomías parciales desde 1986, por lo que nos propusimos evaluar nuestra experiencia desde el punto de vista foniátrico en el manejo de estas intervenciones. La muestra consistió en 3 laringectomías glóticas hasta el 2000 y a partir de ese año: 3 cordectomías vía laringofisura, 4 laringectomías glóticas, 8 hemilaringectomías verticales, 2 laringectomías supraglóticas y 6 laringectomías supracricoideas. De éstas últimas, 5 reconstruidos mediante cricohioidoepiglotopexia (CHEP) y 1 mediante cricohioidopexia (CHP). Se revisó la evaluación de voz y respiración pre y postoperatoria, evolución de la deglución, grado de aspiración y la estrategia de rehabilitación, dieta, tiempo de decanulación (retiro del traqueostomo), retiro de sonda nasogástrica (SNG) y percepción de la voz por el examinador. Se le realizó evaluación foniátrica preoperatoria a 16 de los 23 pacientes operados a partir de 2000. En esta evaluación, todos los pacientes presentaron deterioro franco de los parámetros vocálicos: cualidades de voz, duración fonatoria y parámetros respiratorios: patrón respiratorio, tiempo de retención y emisión, coordinación fonorespiratoria y no se detectaron trastornos deglutorios. En la evaluación postoperatoria: se reportó aspiración en 14 pacientes, la cual se clasificó utilizando la escala de Leipzig y Pearson 7: 8 pacientes grado 1, 1 paciente grado 2, 5 pacientes grado 3. Se inició la rehabilitación foniátrica postoperatoria entre el día 1 y 18, con promedio de 8. La decanulación se realizó entre el día 3 y 78, con promedio de 16 días y el retiro de SNG entre el día 4 y 82, con un promedio de 21 días. Se reportó deglución sin aspiración, en un tiempo variable entre un mes y un año con media de 6 meses. Los resultados son los comparables con los reportados en la literatura.
Assuntos
Humanos , Masculino , Feminino , Laringectomia , Neoplasias Laríngeas/diagnóstico , Fonação , Otolaringologia , VenezuelaRESUMO
En el Servicio de Otorrinolaringología del Hospital "Dr. Domingo Luciani", se reportan laringectomías parciales desde 1986, por lo que nos propusimos evaluar nuestra experiencia desde el punto de vista foniátrico en el malicio de estas intervenciones. La muestra consistió en 3 laringectomías glótivas hasta el 2000 y a partir de ese año: 3 cordectomías vía laringofisura, 4 laringectomías glóticas, 8 hemilaringectomías verticales, 2 laringectomías supraglóticas y 6 laringectomías supracrocoideas. De éstas últimas, 5 reconstruidos mediante cricohioidoepiglotopexia (CHEP) y 1 mediante cricohioidopexia (CHP). Se reviso la evaluación de voz y respiración pre y postoperatoria, evolución de la deglución, grado de aspiración y la estrategia de rehabilitación, dieta, tiempo de decanulación (retiro del traqueostomo), retiro de sonda nasogástrica (SNG) y percepción de la voz por el examinador. Se le realizó evaluación foniátrica preoperatoria a 16 de los 23 pacientes operados a partir del 2000. En esta evaluación, todos los pacientes presentaron deterioro franco de los parámetros vocálicos: cualidades de voz, duración fonatoria y parámetros respiratorios: patrón respiratorio, tiempo de retención y emisión, coordinación fonorespiratona y no se detectaron trastornos deglutorios