Assuntos
Infecções Bacterianas/complicações , Doença Hepática Terminal/complicações , Cirrose Hepática/complicações , Periodontite/complicações , Animais , Infecções Bacterianas/diagnóstico , Assistência Odontológica , Doença Hepática Terminal/diagnóstico , Humanos , Inflamação , Cirrose Hepática/diagnóstico , Camundongos , Modelos Teóricos , Periodontite/diagnóstico , Fatores de RiscoRESUMO
This systematic review aims to evaluate mesenchymal stem cells (MSC) periodontal regenerative potential in animal models. MEDLINE, EMBASE and LILACS databases were searched for quantitative pre-clinical controlled animal model studies that evaluated the effect of local administration of MSC on periodontal regeneration. The systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines. Twenty-two studies met the inclusion criteria. Periodontal defects were surgically created in all studies. In seven studies, periodontal inflammation was experimentally induced following surgical defect creation. Differences in defect morphology were identified among the studies. Autogenous, alogenous and xenogenous MSC were used to promote periodontal regeneration. These included bone marrow-derived MSC, periodontal ligament (PDL)-derived MSC, dental pulp-derived MSC, gingival margin-derived MSC, foreskin-derived induced pluripotent stem cells, adipose tissue-derived MSC, cementum-derived MSC, periapical follicular MSC and alveolar periosteal cells. Meta-analysis was not possible due to heterogeneities in study designs. In most of the studies, local MSC implantation was not associated with adverse effects. The use of bone marrow-derived MSC for periodontal regeneration yielded conflicting results. In contrast, PDL-MSC consistently promoted increased PDL and cementum regeneration. Finally, the adjunct use of MSC improved the regenerative outcomes of periodontal defects treated with membranes or bone substitutes. Despite the quality level of the existing evidence, the current data indicate that the use of MSC may provide beneficial effects on periodontal regeneration. The various degrees of success of MSC in periodontal regeneration are likely to be related to the use of heterogeneous cells. Thus, future studies need to identify phenotypic profiles of highly regenerative MSC populations.
Assuntos
Regeneração Tecidual Guiada Periodontal/métodos , Células-Tronco Mesenquimais , Regeneração/fisiologia , Transplante de Células-Tronco , Animais , Regeneração Óssea , Substitutos Ósseos , Transplante Ósseo , Cementogênese/fisiologia , Bases de Dados Factuais , Polpa Dentária/citologia , Modelos Animais de Doenças , Humanos , Metanálise como Assunto , Osteogênese/fisiologia , Ligamento Periodontal/fisiologia , Alicerces TeciduaisRESUMO
Colorectal cancer (CRC) incidence has increased during the past decades in Spain, being the first malignant tumour in incidence. Observed mortality for CRC is mainly due to liver and lung metastases. The only curative treatment is surgery; new surgical techniques and neoadjuvant treatments have increased the number of surgery candidate patients. Patients should be managed with a multidisciplinary approach that includes imaging techniques, chemotherapy, surgery and pathological assessment. As an answer to this approach, a group of pathology experts interested on CRC liver metastases aimed to review the diagnosis and prognosis of liver mestastases and developed practical recommendations for its assessment. The expert group revised the current literature and prepared questions to be discussed based on available evidence and on their clinical practise. As a result, recommendations for the assessment of tumour regression of liver metastases are proposed, which could be implemented in oncology centres allowing assessment standardisation for these patients. Prospective multi-center studies to evaluate these recommendations validity will further contribute to improve the standard care of CRC liver metastases patients.
Assuntos
Neoplasias Colorretais/patologia , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/cirurgia , Terapia Neoadjuvante , Feminino , Humanos , Neoplasias Hepáticas/secundário , Masculino , EspanhaRESUMO
La enfermedad antimembrana basal glomerular (anti-MBG) es una condición que se manifiesta clínicamente como glomerulonefritis rápidamente progresiva y hemorragia alveolar, también llamada Síndrome Riñón- Pulmón. Se asocia a la presencia de autoanticuerpos dirigidos contra el colágeno tipo IV de la membrana basal glomerular. Las vasculitis sistémicas asociadas a ANCA también pueden manifestarse como Síndrome Riñón-Pulmón, cuadro clínico a veces indistinguible de la enfermedad anti-MBG. La concomitancia de ANCA y anticuerpos anti-MBG en el Síndrome Riñón-Pulmón es del orden de un 30 por ciento, según distintos reportes de la literatura. El perfil clínico, el pronóstico y el rol fisiopatológico de cada anticuerpo en este grupo de pacientes todavía son materia de investigación. El mecanismo patogénico inicial parece ser el daño mediado por ANCA, que puede inducir la aparición de anticuerpos anti-MBG, los que perpetúan el daño en el glomérulo.
Anti-glomerular basement membrane (anti-MBG) disease is a condition that is manifested clinically as rapidly progressive glomerulonephritis and alveolar hemorrhage, also known as Pulmonary-Renal Syndrome. It is associated with the presence of autoantibodies directed against type IV collagen of the glomerular basement membrane. Systemic vasculitis associated with ANCA may also manifest as Pulmonary-Renal Syndrome, sometimes clinically indistinguishable from the anti-MBG disease.The concomitance of ANCA and anti-MBG antibodies in the Pulmonary-Renal Syndrome is about 30 percent, according to various reports in literature. The clinical profile, prognosis and physiopathologic roles of each antibody in this group of patients is still under investigation. The pathogenic mechanism appears to be the initial damage mediated by ANCA, which may induce the appearance of anti-MBG, those who perpetuate the glomerulus damage.
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Doença Antimembrana Basal Glomerular/complicações , Doença Antimembrana Basal Glomerular/imunologia , Pneumopatias/complicações , Pneumopatias/imunologia , Nefropatias/complicações , Nefropatias/imunologia , Anticorpos Anticitoplasma de Neutrófilos , Glomérulos Renais/imunologia , Glomérulos Renais/patologia , Pulmão/imunologia , Pulmão/patologia , SíndromeRESUMO
El síndrome POEMS se caracteriza por la presencia de Polineuropatía, Organomegalia, Endocrinopatía, Gammapatía Monoclonal y Cambios en la Piel. Muchas otras manifestaciones clínicas del síndrome no están incluidas en este acrónimo, como las lesiones óseas osteoescleróticas, edema de papila, sobrecarga de volumen extravascular, trombocitosis, policitemia, acropaquia, hipertensión pulmonar, baja de peso, fatiga, diarrea, compromiso renal y artralgias. Es una patología infrecuente, de mayor prevalencia en varones, con una relación 2:1, preferentemente entre la quinta y sexta década de la vida. Es una enfermedad de curso crónico y tiene sobrevida promedio de 13,8 años en algunas series. La patogenia es desconocida y no existe en la actualidad consenso respecto al tratamiento ni estudios randomizados y controlados que comparen los resultados de diferentes terapias en esta enfermedad.
POEMS syndrome is characterized by the presence of Polyneuropathy, Organomegaly, Endocrinopathies, Monoclonal Gammopathy and Skin changes. Many other clinical manifestations of the syndrome are not included in this acronym, as the osteosclerotic lesions, papillary edema, extravascular volume overload, thrombocytosis, polycythemia, acropaquia, pulmonary hypertension, weight loss, fatigue, diarrhea, arthralgia, and renal involvement. It is an infrequent disease, more prevalent in males with a 2:1 ratio, mostly between the fifth and sixth decades of life. It has a chronic course with an average survival of 13.8 years in some series. The pathogenesis is unknown and currently there is no consensus regarding the treatment or randomized controlled studies comparing the outcomes of different therapies in this disease.
Assuntos
Humanos , Masculino , Adulto , Síndrome POEMS/diagnóstico , Síndrome POEMS/terapiaRESUMO
Lupus erythematosus is a multisystemic disease that compromises principally women in fertile age. The principal affected organs are kidney, SNC, bone marrow and serous membranes. Cardiovascular affection includes pericardium, conduction system, myocardium, valves and coronary arteries. The most frequent valve disease is Libman-Sacks endocarditis, although valvulitis or valve dysfunction can exist as well. The mitral valve is the most affected, followed by the aortic valve. The most frequent valve abnormality is slight to moderate aortic insufficiency, while serious insufficiency or valve disruption is very rare. A physical examination has limited efficacy in the diagnosis of valve disease. A high degree of suspicion associated with echocardiography helps to establish the diagnosis. If surgery is not needed, antiplatelet therapy is recommended for asymptomatic patients, and oral anticoagulation treatment is advised for those with valve disease and evidence of thromboembolic phenomena. Recurrence of the disease has been observed in biological grafts, which makes the use of mechanical prostheses advisable when valve replacement indication exists. The following case shows the clinical evolution of a female patient with a rare but very serious lupus erythematosus complication.
Assuntos
Humanos , Feminino , Doenças das Valvas Cardíacas/etiologia , Lúpus Eritematoso Sistêmico/complicaçõesRESUMO
This article puts forward a new proposal to calculate count, turnaround, response, and service time of work orders in a clinical engineering (CE) department. These are calculated by means of a queuing model as a measurement tool. This proposal was tested in a 600-bed hospital with an inventory of 1094 medical devices and with 6 full-time clinical engineers. In April 1999, a simulation (with ARENA 3.01 developed by System Modeling Corporation) of the working of this proposal was performed with desired values being applied to the queuing model. At the end of 2002, real work order data from the database was recorded. As predicted, the results showed that all the indicators of nonscheduled work orders decreased. Response and turnaround time were reduced from 27 to 0.56 hours and 27.48 to 1.13 hours, respectively. From a backlog of 22 outstanding repair orders per month between April 1999 and January 2000, the number was reduced to 4 in December 2002. The queuing model also helped to measure the positive effects on arrival and service rates when users and CE were trained. The difference between simulated and real values was under 5%.
Assuntos
Engenharia Biomédica , Capacitação em Serviço/organização & administração , Modelos Educacionais , Cuba , Eficiência Organizacional , Capacitação em Serviço/normas , Recursos HumanosRESUMO
Acute static tests were performed to assess Zn toxicity on adults of Cnesterodon decemmaculatus (not sexed), a neotropical fish of wide distribution in the Río de la Plata basin. Tests were carried out with ZnCl2 dissolved in natural waters from the Lower Paraná River, the Río de la Plata Estuary, reconstituted waters of similar composition, tap and distilled waters. Median lethal concentration at 24 h was positively correlated to conductivity and the concentrations of Ca2+, Mg2+, and HCO3- (r=0.99, 0.96, 0.97, 0.99, p<0.05, respectively), being higher at the Río de la Plata Estuary (61.2 mg l(-1)) than at the Lower Paraná River (35.3 mg l(-1)). Contaminant load in the natural waters tested was similar at both sites, being Zn concentration 40 and 44 microg l(-1), respectively. An assay with reconstituted water of similar alkalinity to the estuary showed a simultaneous decrease in HCO3- and dissolved Zn, while the Zn speciation, predicted with a computer program, suggested that Zn2+ precipitated as ZnCO3. The effect of Ca2+ on Zn toxicity is also discussed. Zn toxicity was higher in the Río de la Plata Estuary water than in synthetic water of similar ionic composition (24-h LC50 = 93.2 mg l(-1)), suggesting the synergistic effect of other toxic pollutants such as metals, present in the former which were absent in the later.
RESUMO
Se estudió el contenido metálico del agua de los sedimentos y de los bivalvos (limnoperna fortunei y carbícula fluminea) en el ambiente ribereño de la cuenca del Paraná Bajo y del Río de la Plata. Se registró menor contenido de metales en los bivalvos en el Río de la Plata que en el Bajo Paraná, posiblemente debido a las distintas características de las dos aguas: el Río de la Plata es alcalina, dura y con alto contenido orgánico. La del Bajo Paraná es circuneutra y blanda
Assuntos
Poluição da Água , Metais , Moluscos , CongressoRESUMO
Se estudiaron los contenidos de varios metales y tejidos de plantas durante una temporada de crecimiento. Se anotaron los resultados en relación a la retención de los metales en distintas plantas. Los llanos de inundación ofrecen áreas grandes mayormente dentro de la laguna de sedimento anóxico
Assuntos
Poluição da Água , Metais , CongressoRESUMO
Se estudió el efecto de la descomposición de los residuos sobre la materia orgánica y el ciclaje de los nutrientes en las riberas de los ríos usando experimento en base a bolsas de basura. Se notó que era algo lenta la descomposición llegando al 50o/o de la masa original luego de dos años de incubación. Los pantanos llegan a ser productores de nutrientes a largo plazo por la acumulación de los residuos
Assuntos
Poluição da Água , Macrófitas , CongressoRESUMO
Se realizó una investigación en las concentraciones del amonio y fósforo soluble en el agua de poros durante un período de crecimiento en un área de llanos inundables del Río Paraná Inferior. Se utilizaron dispositivos de equilibrio pasivo "peepers". Se determinaron relaciones bajas de N/P para todo el año. Las concentraciones mayores de amonio y fósforo en los poros conduce a un flujo permanente de nutrientes de los sedimentos
Assuntos
Nitrificação , Nutrientes , Amônia , Inundações , CongressoRESUMO
To develop multivalent vaccines expressing foreign antigens in BCG strains, a genetic system for BCG and Mycobacterium smegmatis is being developed that uses vectors derived from the M. fortuitum pAL5000 plasmid. In this paper we present recent advances of our laboratory in this line of research: i) optimal conditions for M. fortuitum electroporation, ii) demonstration that host range properties of pAL5000-based vectors depend on certain open reading frames, iii) cloning of expression signals derived from the BCG Moreaux 65 kD antigen, and iv) construction of expression vectors for M. smegmatis.
Assuntos
Clonagem Molecular/métodos , Mycobacterium/genética , Vacina BCG/genética , Sequência de Bases , DNA Bacteriano , Eletroporação , Vetores Genéticos , Dados de Sequência Molecular , Plasmídeos , Vacinas Sintéticas/genéticaRESUMO
Four of the five open reading frames (ORFs) present in Myobacterium fortuitum pAL5000 plasmid (ORF1, ORF3, ORF4, and ORF5) are dispensable for replication in M. fortuitum. However, two additional ORFs (ORF1 and ORF5) were necessary for replication in a Myobacterium smegmatis heterologous host containing an efficient plasmid transformation mutation.
Assuntos
Micobactérias não Tuberculosas/genética , Plasmídeos , Replicação do DNA , DNA Bacteriano/genética , Fases de Leitura Aberta , Especificidade da Espécie , Transformação BacterianaRESUMO
A raíz de una epidemia de rubéola, se estudia en el Servicio de Neuropediatría del Instituto Nacional de Salud del Niño de Lima, una casuística de 36 pacientes pre-escolares y escolares con manifestaciones neurológicas severas. Las formas clínicas más frecuentes fueron meningoenecefalitis y encefalitis con transtornos de conciencia y crisis convulsivas generalizadas. En forma poco frecuente o aislada se presentaron casos de cerebelitis, de meningitis, de meningo-panencefalitis sub-aguda y de poliradiculoneuritis. En el 94% de los casos las manifestaciones neurológicas se instalaron en forma rápida, el curso de la enfermedad fue agudo, la evolución corta y el pronóstico inmediato bueno.En un paciente con manengoencefalitis subaguda, la afección inicialmente aguda progresó durante 6 semanas para luego remitir en el lapso de 3 meses y medio, y en un niño con poliradiculoneuritis la mejoría fue discreta en el curso de un mes de observación. Los examenes auxiliares mostraron en el 78% de los pacientes una elevación de 4 veces el título basal de anticuerpos; en los líquidos cefalo-raquídeos de las meningoencefalitis y meningitis un aumento de proteínas y de células generalmente a predominio de linfocitos; en los hemogramas en la etapa aguda, leucocitos con neutrofilia y desviación izquierda y los electroencefalogramas de 8 pacientes registros anormales que no guardaron correlación con la evolución clínica. El diagnóstico se basó en el antecedente epidemiológico de rubéola, en el cuadro clínico y/o en la determinación de anticuerpos específicos por el método de inhibición de la hemaglutinación.
Assuntos
Humanos , Pré-Escolar , Criança , Masculino , Feminino , Encefalite , Líquido Cefalorraquidiano/análise , Líquido Cefalorraquidiano/citologia , Líquido Cefalorraquidiano/imunologia , Meningoencefalite , Rubéola (Sarampo Alemão)/complicações , Rubéola (Sarampo Alemão)/epidemiologia , Rubéola (Sarampo Alemão)/história , Anticorpos/líquido cefalorraquidiano , EletroencefalografiaRESUMO
Revisamos 12 pacientes con enfermedad de Coats (13 ojos) captados en 1979 a 1985 en el Hospital de Pediatría del CMO del IMSS, para elaborar la historia natural de la enfermedad. La prevalencia fue hacia el sexo masculino en 58.3% de los casos con una media en la edad de 7 años. Reportamos un caso de Coats bilateral con visión útil posterior a tratamiento con fotocoagulación y crioterapia y uno de los pacientes más pequeños reportados en la literatura munial de 13 meses que nos confundió inicialmente con retinoblastoma, teniendo que hacer el diagnóstico con estudio histopatológico. La AV final en 10 (83.3%) de nuestros pacientes fue de amaurosis, con glaucoma secundario en 6 y 4 de éstos evolucionaron a ptisis. Solo 2 de nuestro pacientes que se trataron oportunamente con fotocoagulación y crioterapia, conservaron buena agudeza visual