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1.
Phys Chem Chem Phys ; 26(27): 18881-18891, 2024 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-38948936

RESUMO

Positronium (Ps) exhibits the ability to form energetically stable complexes with atoms and molecules before annihilation occurs. In particular, F, a halogen, shows the highest reported positronium binding energy (2.95 eV) in the periodic table. Superhalogens are defined as molecules with electron affinities exceeding that of Cl (3.61 eV), the atom with the highest electron affinity. Building upon the concept of superhalogens, we can define Ps-superhalogens as molecules with Ps binding energies surpassing that of F. This study explores structural and energetic aspects of positronium and positron binding to neutral and anionic superhalogen molecules of the MXk+1 family (M = Li, Na, Be, Mg, B, Al, Si, P; X = F, Cl, Br), respectively and where k represents the highest formal valence of M. We perform multicomponent MP2 calculations for positron systems, which reveal how positron affinities vary with the type and number of halogen atoms present. The analysis of the results emphasizes the predominant role of electrostatic interactions in determining the positron affinity, with negligible effects of electronic and geometric relaxation upon positron attachment. We predict the energetic stability of 22 of the 24 PsMXk+1 complexes with respect to the chemically relevant dissociation channels: e+ emission, Ps emission and M-X bond breaking. Our findings reveal six MFk+1 systems that qualify as Ps-superhalogens, showing a positronium binding energy exceeding 2.95 eV. Of these, AlF4 stands out by setting a new record for the highest positronium binding energy among neutral molecules, reaching 4.36 eV.

2.
Rev. mex. ing. bioméd ; 45(1): 43-59, Jan.-Apr. 2024. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1570002

RESUMO

Abstract This systematic review aims to assess the extent to which biomedical engineering has been applied in the rehabilitation of patients suffering from Guillain-Barré Syndrome (GBS), given the scarcity of information on this topic. We conducted a thorough analysis of research articles, conference abstracts, and case reports published between 2000 and 2023, specifically from ScienceDirect, PubMed, IEEE Xplore, Springer, and Dimensions. 19 articles were extensively discussed, complemented by an additional 40 information sources providing supplementary information. Each paper underwent a meticulous review process by the four authors, where each separately examined the title and abstract of the papers and subsequently provided a thorough examination of the full text; when conflicts arose, a clear consensus was reached through discussion. The analysis of the articles revealed a notable improvement in upper and lower limb function of GBS patients that was facilitated by both custom-made and commercial devices. Likewise, a small handful of other devices have been used (e.g., to improve urinary retention issues). There is a clear opportunity for new research, innovation and applications.


Resumen Esta revisión sistemática tiene como objetivo evaluar hasta qué punto se ha aplicado la ingeniería biomédica en la rehabilitación de pacientes que padecen el Síndrome de Guillain-Barré (SGB), dada la escasez de información sobre este tema. Realizamos un análisis exhaustivo de artículos de investigación, resúmenes de conferencias e informes de casos publicados entre 2000 y 2023, específicamente de ScienceDirect, PubMed, IEEE Xplore, Springer y Dimensions. Se discutieron ampliamente 19 artículos, complementados con 40 fuentes de información adicionales. Cada artículo pasó por un meticuloso proceso de revisión por parte de los cuatro autores, donde cada uno examinó por separado el título y el resumen de los artículos y posteriormente proporcionó un examen exhaustivo del texto completo; cuando surgieron conflictos, se alcanzó un consenso mediante la discusión. El análisis de los artículos reveló una mejora notable en la función de las extremidades superiores e inferiores de los pacientes con SGB que fue facilitada por dispositivos tanto hechos a medida como comerciales. Asimismo, se han creado un pequeño puñado de otros dispositivos, (por ejemplo, para mejorar los problemas de retención urinaria). Existe una clara oportunidad para nueva investigación, innovación y aplicaciones.

3.
J Phys Chem A ; 127(29): 6123-6134, 2023 Jul 27.
Artigo em Inglês | MEDLINE | ID: mdl-37462537

RESUMO

This study presents the Gaussian Process Prior Optimization for Pulse Shaping (GPPOPS) methodology, a novel approach to pulse shaping engineering. Its main objective is to efficiently identify laser pulse shapes that can achieve a desired task encoded in a cost function while being experimentally implementable. The AlH+ molecule was utilized as a test case to find pulse shapes that maximized vibronic transitions. The results demonstrate that optimal pulses can be readily implemented using current laser technology and that their control capabilities can withstand noise. The study emphasizes the benefits of constructing a surrogate approach to the control landscape during the optimization process. This approach is expected to be versatile, efficient and readily implementable in the laboratory. Its demonstrated robustness to noise sets it apart from other numerical pulse shaping engineering methods. By reducing the required experimental labor, this method has the potential to facilitate breakthroughs in quantum engineering.

4.
J Chem Phys ; 158(13): 134101, 2023 Apr 07.
Artigo em Inglês | MEDLINE | ID: mdl-37031104

RESUMO

This work presents an extension of the projector operator embedding scheme of Manby et al. [J. Chem. Theory Comput. 8, 2564 (2012)] in a multicomponent (MC) framework. Here, a molecular system containing electrons and other types of quantum species is divided into a wavefunction (WF) subsystem of interest and a density functional theory (DFT) environment. The WF-in-DFT partition decreases computational costs by partially truncating the WF subsystem basis set at the cost of introducing a controllable embedding error. To explore the applicability of the MC extension, third-order propagator-in-DFT calculations were performed for positron-anion complexes for alkoxides and carboxylates with carbon chains of different sizes. For these systems, it was found that selecting a WF subsystem with the positron and only the oxygen atoms caused an error of 0.1 eV or lower in positron-binding energies, while reducing between 33% and 55% the basis set size. The reduction of computational costs achieved with the embedding scheme allowed us to improve molecular positron-binding energy predictions by performing complete basis set limit extrapolations. Combining the WF-in-DFT embedding and the complete basis set extrapolation, positronium aliphatic alkoxides were predicted to be energetically stable by 0.3 eV with respect to Ps emission. Similarly, positronium carboxylates, both aromatic and aliphatic, were predicted to be stable by 1.3 eV.

5.
Front Pharmacol ; 14: 1143888, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37050899

RESUMO

Small extracellular vesicles are nanosized vesicles (30-200 nm) that can ferry proteins, nucleic acids, and lipids between cells and therefore, have significant potential as biomarkers, drug delivery tools or therapeutic agents. SEVs of endothelial origin have been shown to -among other functions-reduce in vitro ischemia/reperfusion (I/R) injury in cardiomyocytes, but whether a pro-inflammatory state of the endothelium impairs the functionality of these SEVs remains to be elucidated. To test this, human umbilical vein endothelial cells cells were treated with TNF-α 10 ng/mL and the expression of the pro-inflammatory parameters VCAM-1, ICAM-1 and eNOS were determined by Western blot. SEVs were isolated from endothelial cells treated with or without TNF-α 10 ng/mL using size exclusion chromatography. The size and concentration of SEVs was measured by Nanoparticle Tracking Analysis. The expression of the surface marker CD81 was determined by immunoassay, whereas their morphology was assessed by electron microscopy. The function of endothelial SEVs was assessed by evaluating their cardioprotective effect in an ex vivo model of global I/R using isolated hearts from adult C57BL/6 mice. Treatment of HUVECs with TNF-α induced the expression of VCAM-1 and ICAM-1, whereas eNOS levels were decreased. TNF-α did not affect the production, size, morphology, or expression of CD81. SEVs significantly reduced the infarct size as compared with untreated mice hearts, but SEVs isolated from TNF-α treated cells were unable to achieve this effect. Therefore, a pro-inflammatory state induced by TNF-α does not alter the production of endothelial SEVs but impairs their function in the setting of I/R injury.

6.
Acta méd. colomb ; 47(3)July-Sept. 2022.
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1533431

RESUMO

Introduction: Kounis syndrome (KS) is myocardial ischemia secondary to the release of inflam matory mediators (mastocyte degranulation) during an allergic reaction. Adult anaphylaxis is often triggered by medications, of which antibiotics are the most frequently reported. Objective: to study the presentation of and clinical approach to a patient with Kounis syndrome and increase the diagnostic suspicion of a disease which does not have a standardized treatment and is not supported by clinical practice guidelines. Case presentation: we present the case of a 62-year-old adult patient with chest pain and anginal equivalents following perioperative anaphylactic shock during a scheduled open cholecystectomy for gallstones, with subsequent acute myocardial infarction without ST elevation, and coronary artery lesions or atheromatous disease ruled out by arteriography. Conclusions: Kounis syndrome is an underdiagnosed entity with a variable clinical presenta tion and no concrete or standardized treatment. This therefore encourages the development of a greater case history and the structuring of widely disseminated guidelines for its treatment. (Acta Med Colomb 2022; 47. DOI:https://doi.org/10.36104/amc.2022.2289).


Introducción: el síndrome de Kounis (SDK) corresponde a una isquemia miocárdica secundaria a la liberación de mediadores inflamatorios (degranulación de mastocitos) durante una reacción alérgica. La anafilaxia en adultos comúnmente es desencadenada por medicamentos, de los cuales los antibióticos son los más frecuentemente informados. Objetivo: estudiar la forma de presentación y abordaje clínico de un paciente con síndrome de Kounis y aumentar la sospecha diagnóstica de una patología que no tiene un tratamiento estanda rizado o respaldado por guías de práctica clínica. Presentación de caso: se presenta el caso de una paciente adulta de 62 años con dolor pre cordial y equivalentes anginosos posterior a un choque anafiláctico perioperatorio durante una colecistectomía abierta realizada de forma programada por colelitiasis, con posterior infarto agudo de miocardio sin elevación del ST, con arteriografía que descartó lesiones en arterias coronarias o enfermedad ateromatosa. Conclusiones: el síndrome de Kounis es una entidad subdiagnosticada, con presentación clínica variable y sin un tratamiento concreto o estandarizado, lo que motiva a realizar una mayor casuística y estructurar recomendaciones de amplia difusión respecto a su tratamiento. (Acta Med Colomb 2022; 47. DOI:https://doi.org/10.36104/amc.2022.2289).

7.
J Phys Chem B ; 126(14): 2699-2714, 2022 Apr 14.
Artigo em Inglês | MEDLINE | ID: mdl-35377644

RESUMO

We propose a model for solvated positronium (Ps) atoms in water, based on the sequential quantum mechanics/molecular mechanics (s-QM/MM) protocol. We developed a Lennard-Jones force field to account for Ps-water interactions in the MM step. The repulsive term was obtained from a previously reported model for the solvated electron, while the dispersion constant was derived from the Slater-Kirkwood formula. The force field was employed in classical Monte Carlo (MC) simulations to generate Ps-solvent configurations in the NpT ensemble, while the quantum properties were computed with the any-particle molecular orbital method in the subsequent QM step. Our approach is general, as it can be applied to other liquids and materials. One basically needs to describe the solvated electron in the environment of interest to obtain the Ps solvation model. The thermodynamical properties computed from the MC simulations point out similarities between the solvation of Ps and noble gas atoms, hydrophobic solutes that form clathrate structures. We performed convergence tests for the QM step, with particular attention to the choice of basis set and expansion centers for the positronic and electronic subsystems. Our largest model was composed of the Ps atom and 22 water molecules in the QM region, corresponding to the first solvation shell, surrounded by 128 molecules described as point charges. The mean electronic and positronic vertical detachment energies were (4.73 ± 0.04) eV and (5.33 ± 0.04) eV, respectively. The latter estimates were computed with Koopmans' theorem corrected by second-order self-energies, for a set of statistically uncorrelated MC configurations. While the Hartree-Fock wave functions do not properly account for the annihilation rates, they were useful for numerical tests, pointing out that annihilation is more sensitive to the choice of basis sets and expansion centers than the detachment energies. We further explored a model with reduced solute cavity size by changing the Ps-solvent force field. Although the pick-off annihilation lifetimes were affected by the cavity size, essentially the same conclusions were drawn from both models.

8.
Front Cardiovasc Med ; 8: 770421, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34869687

RESUMO

Despite important advances in the treatment of myocardial infarction that have significantly reduced mortality, there is still an unmet need to limit the infarct size after reperfusion injury in order to prevent the onset and severity of heart failure. Multiple cardioprotective maneuvers, therapeutic targets, peptides and drugs have been developed to effectively protect the myocardium from reperfusion-induced cell death in preclinical studies. Nonetheless, the translation of these therapies from laboratory to clinical contexts has been quite challenging. Comorbidities, comedications or inadequate ischemia/reperfusion experimental models are clearly identified variables that need to be accounted for in order to achieve effective cardioprotection studies. The aging heart is characterized by altered proteostasis, DNA instability, epigenetic changes, among others. A vast number of studies has shown that multiple therapeutic strategies, such as ischemic conditioning phenomena and protective drugs are unable to protect the aged heart from myocardial infarction. In this Mini-Review, we will provide an updated state of the art concerning potential new cardioprotective strategies targeting the aging heart.

9.
Clin Transl Sci ; 14(6): 2254-2266, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34415683

RESUMO

This multicenter clinical study was aimed at conducting a targeted pharmacogenomic association analysis of residual on-clopidogrel platelet reactivity in 474 Caribbean Hispanic patients. Platelet reactivity was measured using the VerifyNow P2Y12 assay and clopidogrel resistance was defined as P2Y12 reaction units (PRUs) greater than or equal to 208. Genotyping was performed using the whole-genome Infinium MEGA BeadChip array. An ancestry-adjusted, weighted polygenic risk score (wPGxRS) was developed to account for the effect of multiple variants on PRU and compared between clopidogrel responders and nonresponders. The mean PRU across the study cohort was 173.8 ± 68.5 and 33.5% of patients were defined as clopidogrel resistant. Multivariate linear regression showed that 19% of PRU variability was attributed to nine independent predictors, with CYP2C19*2 (rs4244285) accounting for ~ 7% of observed PRU variation (p < 0.001). PON1 rs662, ABCB1/MDR1 rs2032582, PEAR1 rs12041331 carrier status, and the interaction between African ancestry and rs12041331 carriers also predicted PRU among the participants (p ≤ 0.05). A clear gene-dose effect was detected between PRU and CYP2C19*2 genotype, consistent with previous studies in European patient populations, as well as rs12777823. Importantly, a significant positive correlation was detected between our novel wPGxRS (4 variants) and PRU among the Hispanic patient population (rp  = 0.35, p < 0.001). Moreover, the wPGxRS discriminated between nonresponders and responders (p = 0.003), indicating that this multigene-based score is a useful predictor of clopidogrel resistance among Caribbean Hispanics. Taken together, these results help close the gap of knowledge on clopidogrel pharmacogenomics and its potential clinical implementation in this under-represented population.


Assuntos
Clopidogrel/farmacologia , Hispânico ou Latino/genética , Herança Multifatorial , Farmacogenética , Inibidores da Agregação Plaquetária/farmacologia , Idoso , Feminino , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Índias Ocidentais/etnologia
10.
Front Pharmacol ; 12: 636134, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33603675

RESUMO

Despite considerable improvements in the treatment of myocardial infarction, it is still a highly prevalent disease worldwide. Novel therapeutic strategies to limit infarct size are required to protect myocardial function and thus, avoid heart failure progression. Cardioprotection is a research topic with significant achievements in the context of basic science. However, translation of the beneficial effects of protective approaches from bench to bedside has proven difficult. Therefore, there is still an unmet need to study new avenues leading to protecting the myocardium against infarction. In line with this, the endothelium is an essential component of the cardiovascular system with multiple therapeutic targets with cardioprotective potential. Endothelial cells are the most abundant non-myocyte cell type in the heart and are key players in cardiovascular physiology and pathophysiology. These cells can regulate vascular tone, angiogenesis, hemostasis, and inflammation. Accordingly, endothelial dysfunction plays a fundamental role in cardiovascular diseases, which may ultimately lead to myocardial infarction. The endothelium is of paramount importance to protect the myocardium from ischemia/reperfusion injury via conditioning strategies or cardioprotective drugs. This review will provide updated information on the most promising therapeutic agents and protective approaches targeting endothelial cells in the context of myocardial infarction.

11.
Rev. chil. pediatr ; 91(7): 75-90, set. 2020. tab, graf
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1138697

RESUMO

Resumen: La pandemia por COVID-19, originada en diciembre de 2019 en Wuhan, China, obligó a los países, incluido Chile, a un confinamiento masivo para evitar la propagación de SARS-CoV2. Desde marzo de 2020 en Chile, también se afectó la realización de actividad física y deporte en los niños, niñas y adolescentes (NNA). En un esfuerzo por reunir la escasa evidencia disponible sobre el retorno a la práctica de ejercicio en NNA post pandemia COVID-19 y la opinión de expertos de 4 sociedades científicas y académicas (Sociedad Chilena de Medicina del Deporte, Sociedad Chilena de Pediatría, Sociedad Chilena de Kinesiología Deportiva y la Consejo Académico Nacional de Educación Física) se han generado recomendaciones para un retorno seguro a la actividad para el ramo Educación Física y Salud, deporte escolar y federado tanto para disminuir los riesgos asociados a los efectos del confinamiento como para evitar la propagación de COVID-19. Adicionalmente, se incluyen una guía de recomendación para padres y profesores y otra para médicos sobre la vigilancia y evaluación de los pacientes NNA que sostendrán enfermedad COVID-19 y deseen volver al deporte y ejercicio.


Abstract: The COVID-19 pandemic, originated in December 2019 in Wuhan, China, forced a massive quaran tine in most countries including Chile to avoid the propagation of SARS-CoV2. Since March 2020 in Chile, it affected the participation of children and youth athletes as well in education, physical activity and sports. In an effort to assess the scarce available evidence about return to sport and exercise in children and adolescents post COVID-19 pandemic and gather the opinion of experts of 4 Chilean scientific and academic societies (Sociedad Chilena de Medicina del Deporte, Sociedad Chilena de Pediatría, Sociedad Chilena de Kinesiología Deportiva and Consejo Académico Nacional de Edu cación Física) we have produced recommendations for a safe return to activities in Physical Activity and Health class, School Sports and Federation Sports to reduce the risks associated with the effects of confinement and to avoid the propagation of COVID-19 and. Additionally, a recommendation for parents and teachers and a another for physicians for surveillance and evaluation of children and adolescents who were or will become COVID-19 patients and wish to return to sports end exercise.

12.
Rev. chil. cardiol ; 39(1): 66-74, abr. 2020. graf
Artigo em Espanhol | LILACS | ID: biblio-1115452

RESUMO

En 31 de diciembre del 2019 la Organización Mundial de la Salud fue informada por las autoridades sanitarias chinas de la aparición de casos de neumonía de origen desconocido en la ciudad de Wuhan en China. El 7 de Enero de 2020, científicos chinos identificaron a un nuevo coronavirus (temporalmente designado como "2019-nCoV") como el agente etiológico de la enfermedad denominada COVID-19. La secuenciación del genoma del nuevo coronavirus mostró gran similitud con el coronavirus (Covid-1 o SARS-CoV) causante del síndrome respiratorio agudo severo (SARS), ocurrido también en China entre los años 2002-2003. Por este motivo, 2019-nCoV se rebautizó como SARS-CoV-2 (Severe Acute Respiratory Syndrome Corona Virus-2) y a la fecha es responsable de la actual y grave pandemia que está ocasionando impactos sanitarios y socio-económicos a escala global. Las investigaciones con SARS-CoV establecieron que este virus ingresa a nuestras células utilizando como receptor a la enzima convertidora de angiotensina tipo 2 (ECA 2 o en inglés ACE-2: "angiotensin converting enzyme type 2"). Dado este antecedente también se confirmó que SARS-CoV-2 también utiliza esta misma enzima ya que no se habla de un mecanismo en si para ingresar a sus células blanco, especialmente a nivel de nuestro sistema respiratorio. ECA-2 es una proteasa integrante del sistema renina angiotensina "alterno o no canónico" con importantes acciones regulatorias sobre los sistemas cardiovascular, renal y pulmonar, entre otros. En este contexto, ha surgido preocupación tanto por clínicos como los propios pacientes respecto al estado de pacientes hipertensos con COVID-19 y su vulnerabilidad a infectarse con SARS-CoV-2 dado que algunos trabajos han planteado que ciertos polimorfismos en el gen ECA-2 asociados a hipertensión arterial podrían determinar una mayor expresión de ECA-2. Además, estudios preclínicos han sugerido que ciertos fármacos antihipertensivos (principalmente, inhibidores de ECA y antagonistas del receptor para angiotensina II subtipo 1) también podrían estimular una mayor expresión de ECA-2. Esta revisión tiene por objetivo presentar y discutir los antecedentes en el estado del arte respecto a esta reciente problemática. El análisis crítico de los presentes antecedentes permite concluir que no existe evidencia clínica sólida que permita afirmar que el uso de medicamentos antihipertensivos genere una mayor vulnerabilidad a la infección con SARS-CoV-2. Por lo tanto no se debe descontinuar su uso en pacientes hipertensos en riesgo de infección a SARS-CoV-2 o que padezcan COVID-19.


In December 2019, a new type of coronavirus emerged in the city of Wuhan, China. This novel virus has unleashed a pandemic that has inflicted a considerable impact on public health and the economy and has therefore become a severe concern worldwide. This new virus -named SARS-CoV-2has been rapidly investigated in order to create knowledge aimed at achieving its control. Comparative studies with SARS-CoV virus, responsible for the 2002-2003 pandemic, suggest that SARS-CoV-2 requires the same receptor to bind and infect cells: angiotensin converting enzyme 2 (ACE-2). This hypothesis has been thoroughly supported by a variety of in vitro research and is currently considered a potential therapeutic target. ACE-2 is part of the counter-regulatory renin-angiotensin system, exerting effects in pulmonary, renal and cardiovascular systems. In this context, concerns have arisen in regards to the vulnerability of hypertensive patients against COVID-19, given that there is evidence that may suggest that polymorphisms associated to hypertension may increase the expression of ACE-2. Moreover, preclinical studies have shown that antihypertensive drugs may increase the expression of this enzyme. In this review article, we present the current state of the art on this polemic topic. Our critical analysis suggest that there is no robust clinical evidence supporting the hypothesis that the use of antihypertensive drugs can increase vulnerability to infection with SARS-CoV-2. Therefore, we recommend that the use of these therapeutic agents should not be discontinued in hypertensive patients in risk to or suffering COVID-19.


Assuntos
Humanos , Pneumonia Viral/complicações , Infecções por Coronavirus/complicações , Hipertensão/complicações , Hipertensão/tratamento farmacológico , Anti-Hipertensivos/uso terapêutico , Pneumonia Viral/metabolismo , Sistema Renina-Angiotensina , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Infecções por Coronavirus/metabolismo , Peptidil Dipeptidase A/genética , Peptidil Dipeptidase A/metabolismo , Pandemias , Betacoronavirus/metabolismo , Hipertensão/metabolismo
13.
ACS Appl Mater Interfaces ; 12(1): 914-924, 2020 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-31805231

RESUMO

Within the most mesmerizing materials in the world of optoelectronics, mixed halide perovskites (MHPs) have been distinguished because of the tunability of their optoelectronic properties, balancing both the light-harvesting efficiency and the charge extraction into highly efficient solar devices. This feature has drawn the attention of analogous hot topics as photocatalysis for carrying out more efficiently the degradation of organic compounds. However, the photo-oxidation ability of perovskite depends not only on its excellent light-harvesting properties but also on the surface chemical environment provided during its synthesis. Accordingly, we studied the role of surface chemical states of MHP-based nanocrystals (NCs) synthesized by hot-injection (H-I) and anion-exchange (A-E) approaches on their photocatalytic (PC) activity for the oxidation of ß-naphthol as a model system. We concluded that iodide vacancies are the main surface chemical states that facilitate the formation of superoxide ions, O2●-, which are responsible for the PC activity in A-E-MHP. Conversely, the PC performance of H-I-MHP is related to the appropriate balance between band gap and a highly oxidizing valence band. This work offers new insights on the surface properties of MHP related to their catalytic activity in photochemical applications.

14.
Rev. chil. ortop. traumatol ; 61(3): 108-111, 2020. ilus
Artigo em Espanhol | LILACS | ID: biblio-1177822

RESUMO

El carcinoma de células renales es el 7mo cáncer en frecuencia a nivel mundial con más de 300.000 casos nuevos al año y es la 3era malignidad genitourinaria más frecuente. El sitio más común de metástasis es el pulmón mientras que el esqueleto ocupa el segundo lugar con una frecuencia que varía entre un 20% a un 35%. Se ha reportado una sobrevida de 12 meses en promedio luego de la aparición de metástasis óseas. Reporte del caso de un paciente con diagnóstico de cáncer renal de células claras y metástasis óseas (en columna, pelvis y ambos húmeros), que evoluciona con fractura de ambos brazos. El paciente es aceptado en un ensayo clínico de tratamiento con inmunoterapia y además se somete a una reducción y osteosíntesis bilateral de húmero con clavo endomedular, logrando la consolidación de ambas fracturas y, por ende, la regresión de la enfermedad.


Renal cell carcinoma is ranked 7th in frequent cancer worldwide with more than 3000.000 new cases per year, as well as it's ranked 3rd in frequent genitourinary malignancy. The most common area of metastases is lung followed by skeleton in second place. The frequency of skeleton metastases varies from 20% to 35%. A survival average time of 12 months is generally observed after the appearance of bone metastases. This case report is about a patient diagnosed with clear cell renal cancer and bone metastases (in the spine, pelvis and both humerus) that evolves with fracture of both arms. The patient undergoes a clinical trial with immunotherapy and also a reduction and osteosynthesis of both arms with intramedullary nail, achieving consolidation of both fractures and regression of the disease.


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Ósseas/secundário , Carcinoma de Células Renais/secundário , Fraturas do Úmero/etiologia , Neoplasias Renais/patologia , Neoplasias Ósseas/complicações , Carcinoma de Células Renais/complicações , Carcinoma de Células Renais/terapia , Fixação Interna de Fraturas , Fraturas do Úmero/cirurgia , Fraturas do Úmero/diagnóstico por imagem , Imunoterapia , Neoplasias Renais/terapia
15.
Artrosc. (B. Aires) ; 27(2): 51-56, 2020.
Artigo em Espanhol | LILACS, BINACIS | ID: biblio-1118218

RESUMO

Introducción: Evaluar la precisión de la cirugía artroscópica de Latarjet­Bankart, mediante tomografía computada post operatoria. Describir resultados y complicaciones en la primera serie prospectiva de esta técnica en Chile.Material y Método: Quince pacientes fueron sometidos a cirugía de estabilización mediante la técnica artroscópica de Latarjet­Bankart. Se realizó una evaluación de la posición del injerto de coracoides mediante tomografía computada considerando los índices: ángulo tornillo - superficie articular, tornillo excesivamente largo, distancia línea articular - borde injerto en plano axial (método tangente), distancia borde injerto ­ superficie articular (método del círculo) en planos axial y coronal y relación posición injerto ­ diámetro glenoideo.Resultados: Se obtuvo un ángulo tornillo ­ superficie promedio de 32.9°. En un paciente se objetivó un tornillo de largo excesivo (+ 4 mm). De acuerdo al método tangente axial la distancia fue de 0 mm [0 mm ­ 2,5 mm], método circulo axial 0 mm [-0,8 mm ­ 1 mm], circulo coronal 0 mm [-1 mm ­ 2 mm]. En el 100% de los casos la posición injerto ­ diámetro glenoideo, fue bajo el 50% o subecuatorial. El injerto se encontró en posición "flush" en todos los pacientes. En un paciente fue necesario convertir a cirugía abierta. En un paciente ocurrió una factura parcial del injerto y un paciente presento una fractura de glenoides y una plexitis transitoria de 5 semanas. Un 13% de los pacientes presentó recurrencia al seguimiento a los 2 años.Conclusión: Es factible realizar esta técnica quirúrgica de manera artroscópica, con una baja necesidad de conversión y complicaciones, logrando una posición óptima del injerto.Tipo de estudio: Serie de Casos. Nivel de Evidencia: IV


Introduction: Evaluate the feasibility and precision of arthroscopic Latarjet-Bankart surgery, using computed tomography. Describe outcomes and complications in the first prospective series of this technique in Chile.Method: Fifteen patients underwent surgery using the arthroscopic Latarjet-Bankart technique. We evaluated the position of the coracoid graft by Computed Tomography, considering the following indices: screw angle - joint surface, excessively long screw incidence, joint line distance - graft edge in axial plane (tangent method), distance graft edge - joint surface (circle method) in axial and coronal planes, graft position relationship - glenoid diameter. Results: A screw angle - surface 32.9 ° was obtained. In one patient a screw of excessive length (+ 4mm). According to the axial tangent method the distance was 0mm [0mm - 2.5mm], axial circle method 0mm [-0.8mm - 1mm], coronal circle 0mm [-1mm - 2mm], in 100% of the cases the graft position - glenoid diameter was under 50% or subequatorial. The graft was found in the "flush" position in all patients. In one patient was necessary to convert to open surgery. One patient with partial graft fracture. One patient had a major complication, which was a glenoid fracture and a transient plexitis of 5 weeks. Instability recurrence was observed in 13% of patients at 2 years follow-up.Conclusion: It's feasible to perform this technique arthroscopically, with a low conversion and complications rate, obtaining an optimal position of the graft. Type study: Case Series. Level of Evidence: IV


Assuntos
Adulto , Artroscopia/métodos , Luxação do Ombro , Articulação do Ombro/cirurgia , Articulação do Ombro/lesões , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Instabilidade Articular
16.
Rev. venez. cir ; 73(2): 41-44, 2020. ilus
Artigo em Espanhol | LILACS, LIVECS | ID: biblio-1292295

RESUMO

La hernia de Spiegel es un defecto infrecuente de la pared abdominal producido por una alteración en la unión del borde lateral del músculo recto del abdomen y el borde medial del músculo transverso del abdomen en la línea semilunar. Representan apenas del 0,12 al 2% de todas las hernias. La presente investigación se enfocó en describir las manifestaciones clínicas, el diagnóstico, la incidencia, el procedimiento quirúrgico y su evolución en dos casos reportados. Caso 1: Femenina de 33 años, multípara, obesa, quien consulta por dolor y masa palpable en el cuadrante superior izquierdo del abdomen. Al examen físico, se evidenció dolor a la palpación en mesogastrio e hipocondrio izquierdo, exhibiendo protrusión del contenido abdominal, en la línea de Spiegel. Intervención quirúrgica: hernioplastia protésica de Spiegel con colocación de malla supraaponeurótica. Caso 2: Masculino de 89 años, con diagnóstico de EPOC, acudió a consulta presentando dolor abdominal en fosa iliaca y en la región inguino­escrotal izquierda. Al examen físico se evidenció saco herniario en la región inguino­escrotal por lo que se decide su resolución quirúrgica. Como hallazgo transoperatorio se evidenció defecto aponeurótico del recto anterior del abdomen izquierdo en su tercio inferior. Intervención quirúrgica: hernioplastia protésica de Spiegel con colocación de malla supraaponeurótica.Conclusión : La hernia de Spiegel es una entidad poco frecuente por lo que se debe concientizar al cirujano para sospechar este tipo de hernia en aquellos pacientes con presencia de aumento de volumen en la línea de Spiegel(AU)


Spigelian hernia is an infrequent abdominal wall defect caused by an alteration in the joint between lateral edge of the rectus abdominis muscle and the medial egde of the transverse abdominis muscle in the semilunar line. It represent only from 0.12 to 2% of all hernias. This investigation is focussed on describe the clinical manifestations, diagnosis, incidence, the surgical procedure and its evolution in two reported cases. Case 1: A 33 years old female, multiparous, obese, who consulted for pain and palpable mass in the left upper quadrant of the abdomen. Physical examination revealed tenderness between mesogastrium and left hypochondrium, showing protrusion of abdominal content, in the Spigelian line. Surgical intervention: Prosthetic Spiegel hernioplasty with supraaponeurotic mesh. Case 2: An 89 years old male, diagnosed with COPD, attended in the consultation presenting abdominal pain in the iliac fossa and in the left inguino-scrotal region. Physical examination revealed hernial sac in the inguino-scrotal region, reason which its surgical resolution is decided. As an intraoperative finding, an aponeurotic defect of the anterior rectus of the left abdomen was evidenced in its lower third. Surgical intervention: Prosthetic Spiegel hernioplasty with supraaponeurotic mesh.Conclusion : Spigelian hernia is a rare entity, so the surgeon must be focused on suspect this kind of hernia in patients with growth in Spiegel line(AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Idoso de 80 Anos ou mais , Dor Abdominal/etiologia , Dor Abdominal/diagnóstico por imagem , Anti-Inflamatórios não Esteroides , Hérnia Abdominal/cirurgia , Exame Físico , Cirurgia Geral , Incidência
17.
J Mol Model ; 25(10): 316, 2019 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-31529219

RESUMO

A computational scheme is proposed to broaden the range of applications of multicomponent methodologies for the study of local properties of big molecular systems existing in the gas phase and in solvated environments. This scheme extends the any particle molecular orbital (APMO) approach in the quantum mechanics/molecular mechanics (QM/MM) framework. As a first assessment of the performance of the proposed approach, we estimate the proton affinities (PAs) of seventy amines in the gas phase and the proton binding energies (PBEs) in the gas phase and in an explicitly solvated environment of the sixty-one protons present in the chignolin protein. These calculations are performed with the QM/MM versions of the APMO second-order proton propagator (APMO-PP2) and the APMO extended Koopmans' theorem (APMO-KT) approaches. Calculated PAs and PBEs show significant reductions in the computational effort with a reduced loss in accuracy. These results suggest that the APMO/MM scheme might be used as a low-cost multi-component alternative for studies of local properties in big molecular systems. Graphical Abstract QMMM regions and CPU times for the APMO/MM approach.

18.
Nanoscale ; 11(2): 762-774, 2019 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-30566154

RESUMO

In quantum dot sensitized solar cells (QDSSC), a cascade energy level structure controlled by assembly of cadmium-chalcogenide quantum dots can remarkably improve the sunlight harvesting and charge carrier lifetime. Despite the advantages of using co-sensitizers, energy conversion efficiencies are still low. An increased understanding of the causes of the low photoconversion efficiency (PCE) will contribute to the development of a straightforward approach to improve solar cell performance by exploiting co-sensitization. Herein we discuss how an excess of cadmium causes structural disorder and defect levels impacting the PCE of QDSSC devices. Thus, outer CdS1-xSex/inner CdS QD-co-sensitized B,N,F-co-doped-TiO2 nanotubes (BNF-TNT) were prepared. Chalcogenides were deposited by the SILAR method on BNF-TNT, varying the load of CdS as the inner sensitizer, while for CdS1-xSex, five SILAR cycles were used (5-CdS1-xSex), controlling the nominal S/Se molar ratio of the ternary alloy. Cd defects named as Cd-Cd energy levels were observed during CdS sensitization. Although incorporation of outer CdS1-xSex provides a tunable band gap to achieve good band alignment for carrier separation, Cd-Cd energy levels in the sensitizers act as recombination centers, limiting the overall electron flow at the BNF-TNT/CdS/CdS1-xSex interface. A maximum PCE of 2.58% was reached under standard AM 1.5G solar illumination at 100 mW cm-2. Additional limitations of SILAR as a deposition strategy of QDs are also found to influence the PCE of QDSSC.

19.
Rev. colomb. nefrol. (En línea) ; 5(1): 61-67, Jan.-June 2018. graf
Artigo em Inglês | LILACS, COLNAL | ID: biblio-1093007

RESUMO

Abstract The current perspective on the management of infectious diseases is a challenge for clinicians, because while new antibiotics are developed, bacteria improves its resistance system. That is why this study presents CANTHARIS 9 CH as an alternative treatment for urinary tract infection. This drug has an homeopathic use and it has been tested on humans as an urinary prophylactic. In this text, we present two cases of patients who voluntarily accept to receive this new protocol. Both cases show laboratory confirmation of infection, with quinolone resis tance, among others, and negativization post-treatment with CANTHARIS 9 CH. No side effects were reported in this sample.


Resumen La actual perspectiva en el manejo de enfermedades infecciosas es un reto para el clínico, en la medida en que se desarrollan nuevos antibióticos, las bacterias mejoran su sistema de resistencia. Por esto, este estudio presenta una alternativa al tratamiento de infección urinaria con CANTHARIS 9 CH, medicamento de uso homeopático que tiene estudios en humanos como profiláctico urinario. Se presentan dos casos de pacientes que aceptan voluntariamente recibir este nuevo protocolo. En ambos casos se muestra una confirmación microbiológica de la infección, con resistencia a quinolonas, entre otros, y negativización post tratamiento con el medicamento CANTHARIS 9 CH. No se reportaron efectos secundarios en esta muestra.


Assuntos
Humanos , Masculino , Feminino , Infecções Urinárias , Cantharis vesicatoria , Terapias Complementares , Colômbia , Infecção Focal
20.
Angew Chem Int Ed Engl ; 57(29): 8859-8864, 2018 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-29770555

RESUMO

We report sufficient theoretical evidence of the energy stability of the e+ ⋅H22- molecule, formed by two H- anions and one positron. Analysis of the electronic and positronic densities of the latter compound undoubtedly points out the formation of a positronic covalent bond between the otherwise repelling hydride anions. The lower limit for the bonding energy of the e+ ⋅H22- molecule is 74 kJ mol-1 (0.77 eV), accounting for the zero-point vibrational correction. The formation of a non electronic covalent bond is fundamentally distinct from positron attachment to stable molecules, as the latter process is characterized by a positron affinity, analogous to the electron affinity.

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