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Introdução: A taxa de mortalidade em pacientes queimados diminuiu significativamente, tornando importante avaliar outros desfechos, como o tempo de internação, que aumenta a morbidade física e psicológica, o risco de infecção hospitalar e os custos financeiros. O objetivo deste estudo é analisar a relevância de vários fatores no tempo de internação na Unidade de Queimados. Método: Foram incluídos neste estudo 711 pacientes admitidos entre 2011 e 2020 na Unidade de Queimados do Hospital de São José, Centro Hospitalar Lisboa Central, Lisboa, Portugal. Os dados coletados foram analisados utilizando o PSPP para Windows. Resultados: Os pacientes eram predominantemente do sexo masculino, com idade média de 54 anos. O tempo médio de permanência hospitalar foi de 29 dias. Os fatores que prolongaram a estadia hospitalar foram relacionados à gravidade da queimadura, ao número de cirurgias e ao tempo decorrido até a primeira cirurgia, valores laboratoriais alterados tanto no perfil hematológico quanto químico durante a hospitalização, e a presença e o número de infecções documentadas. Conclusão: Existem fatores potencialmente modificáveis que infiuenciam o tempo de permanência hospitalar. Nosso estudo nos permite concluir que o tempo decorrido até a primeira intervenção cirúrgica e a presença e o número de infecções documentadas prolongam significativamente esse desfecho, e ênfase deve ser dada à implementação de medidas que favoreçam a intervenção cirúrgica precoce e o controle rigoroso de infecções.
Introduction: Burn patients' mortality rate has decreased significantly, making it important to evaluate other outcomes, such as length-of-stay, which increases physical and psychological morbidity, risk of nosocomial infection, and financial costs. The objective of this study is to analyze the relevance of several factors in the Burn Unit length-of-stay. Material and Methods: 711 patients were included in this study, admitted between 2011 and 2020 to the Burn Unit at São José Hospital, Centro Hospitalar Lisboa Central, Lisbon, Portugal. Collected data was analyzed using PSPP for Windows. Results: Patients included in the study were predominantly males, with a mean age of 54 years. The mean length of stay was 29 days. The factors that prolonged in-hospital stay were those related to the severity of the burn, the number of surgeries and the time elapsed until the first one, altered laboratory values in both hematologic and chemistry profile during the hospitalization, and the presence and number of documented infections. Conclusion: There are potentially modifiable factors that influence length-of-stay. Our study allows us to conclude that the time elapsed until the first surgical intervention and the presence and number of documented infections significantly prolong this outcome, and emphasis should be given to the implementation of measures that favor early surgical intervention and strict infection control.
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ABSTRACT Purpose The clinical outcomes of kidney transplantation from deceased donors have seen significant improvements with the use of machine perfusion (MP), now a standard practice in transplant centers. However, the use of perfusate biomarkers for assessing organ quality remains a subject of debate. Despite this, some centers incorporate them into their decision-making process for donor kidney acceptance. Recent studies have indicated that lactate dehydrogenase (LDH), glutathione S-transferase, interleukin-18, and neutrophil gelatinase-associated lipocalin (NGAL) could predict post-transplant outcomes. Materials and Methods Between August 2016 and June 2017, 31 deceased-donor after brain death were included and stroke was the main cause of death. Pediatric patients, hypersensitized recipients were excluded. 43 kidneys were subjected to machine perfusion. Perfusate samples were collected just before the transplantation and stored at -80ºC. Kidney transplant recipients have an average age of 52 years, 34,9% female, with a BMI 24,6±3,7. We employed receiver operating characteristic analysis to investigate associations between these perfusate biomarkers and two key clinical outcomes: delayed graft function and primary non-function. Results The incidence of delayed graft function was 23.3% and primary non-function was 14%. A strong association was found between NGAL concentration and DGF (AUC=0.766, 95% CI, P=0.012), and between LDH concentration and PNF (AUC=0.84, 95% CI, P=0.027). Other perfusate biomarkers did not show significant correlations with these clinical outcomes. Conclusion The concentrations of NGAL and LDH during machine perfusion could assist transplant physicians in improving the allocation of donated organs and making challenging decisions regarding organ discarding. Further, larger-scale studies are required.
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Introdução:O transplante autólogo dentário é uma técnica cirúrgica na qual há a transposição de um dente para uma nova área receptora, no mesmo paciente. É viável para o tratamento de ausências e impactações dentárias. O método apresenta benefícios como manutenção de periodonto vital, volume ósseo alveolar e papila dentária, possibilidade de movimentação dentária por forças ortodônticas ou fisiológicas e estética favorável.Objetivo:Promover uma revisão de literatura sobre o transplante dentário autólogo, visando relatar as principais indicações, benefícios e contraindicações da técnica, além de descrever o protocolo cirúrgico e os fatores que influenciam no sucesso, de modo a orientar o manejo clínico.Metodologia:Para esse fim, as bases de dados analisadas foram PUBMED, LILACS e SCIELO, sendo obtidos artigos de Revisão Sistemática e Metanálises dos anos de 2018 a 2023.Resultados:O autotransplante apresenta taxas de sobrevida entre 93% e 100% e taxas de sucesso entre 89,4% e 96,6%, o que depende dos fatores relacionados ao paciente, ao dente doador, à área receptora e à técnica cirúrgica.Dentes anteriores e com ápice aberto apresentam melhores taxas de sobrevivência e sucesso em relação aos dentes posteriores e de ápice fechado, todavia não há comprovação que os demais pontos realmente influenciam diretamente no método. Conclusões:Com isso, podemos compreender que o estabelecimento de protocolos pré,trans e pós-operatório, além de esclarecimento de todos os fatores que influenciam na técnica, devem ser foco de estudos dos Cirurgiões-Dentistas, trazendo benefícios consideráveisparao manejo cirúrgico e saúde desses pacientes (AU).
Introduction:Autologous dental transplantation is a surgical technique in which there is the transposition of a tooth to a new recipient area within the same patient. It is a viable option for treating dental absenteeism and impactions. The method offers benefits such as the maintenance of vital periodontium, alveolar bone volume, and dental papilla, the possibility of dental movement through orthodontic or physiological forces, and favorable aesthetics.Objective:To promote a literature review on autologous dental transplantation, aiming to report the main indications, benefits, and contraindications of the technique, in addition to describe the surgical protocol and factors influencing success, providing guidance for clinical management.Methodology:For this purpose, the analyzed databases included PUBMED, LILACS, and SCIELO, obtaining Systematic Review and Meta-Analysesarticles from the years 2018 to 2023.Results:Autotransplantation presents survival rates between 93% and 100% and success rates between 89.4% and 96.6%, depending on factors related to the patient, the donor tooth, the recipient area, and the surgical technique. Anterior teeth with open apices present better survival and success rates compared to posterior teeth with closed apices, however, there is no conclusive evidence that other factors directly influence the method.Conclusions:Therefore, we can understand that the establishment of preoperative, intraoperative, and postoperative protocols, along with clarification of all factors influencing the technique, should be the focus of studies for Dental Surgeons, bringing significant benefits to these individuals' health (AU).
Introducción: : El trasplante autólogo dental es una técnica quirúrgica en la que se transpone un diente a una nueva área receptora, en el mismo paciente. Es viable para el tratamiento de ausencias e impactos dentales. El método presenta beneficios como mantenimiento de periodonto vital, volumen óseo alveolar y papila dental, posibilidad de movimiento dental por parte de fuerzas ortodoncias o fisiológicas y estética favorable.Objetivo: Promover una revisión de la literatura sobre el trasplante dentario autólogo, con el objetivo de reportar las principales indicaciones, beneficios y contra indicaciones de la técnica, además de describir el protocolo quirúrgico ylos factores que influyen en el éxito, con el fin de orientar el manejo clínico.Metodología: Para este fin, las bases de datos analizadas fueron PUBMED, LILACS y SCIELO, siendo obtenidos artículos de Revisión Sistemática y Metanálisis de los años 2018 a2023.Resultados: El autotrasplante presenta tasas de sobrevida entre 93% y 100% y tasa de éxito entre 89,4% y 96,6%, lo que depende de los factores relacionados con el paciente, el donante, el área receptora y la técnica quirúrgica. Los dientes anteriores y ápice abiertos presentan mejores tasas de supervivencia y éxito con respecto a los dientes posteriores y de ápice cerrado, pero no hay prueba de que los demás puntos realmente influyen directamente en el método.Conclusiones: Con eso, podemos comprender que el establecimiento de protocolos pre, intra y postoperatorio, además de esclarecimiento de todos los factores que influyen en la técnica, deben ser foco de estudios de los CirujanosDentistas, trayendo beneficios considerables para la salud de estos individuos (AU).
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Cirurgia Bucal , Dente/transplante , Transplante Autólogo/efeitos adversos , Taxa de Sobrevida , Resultado do TratamentoRESUMO
Exposure to the non-protein amino acid cyanotoxin ß-N-methylamino-L-alanine (BMAA), released by cyanobacteria found in many water reservoirs has been associated with neurodegenerative diseases. We previously demonstrated that BMAA induced cell death in both retina photoreceptors (PHRs) and amacrine neurons by triggering different molecular pathways, as activation of NMDA receptors and formation of carbamate-adducts was only observed in amacrine cell death. We established that activation of Retinoid X Receptors (RXR) protects retinal cells, including retina pigment epithelial (RPE) cells from oxidative stress-induced apoptosis. We now investigated the mechanisms underlying BMAA toxicity in these cells and those involved in RXR protection. BMAA addition to rat retinal neurons during early development in vitro increased reactive oxygen species (ROS) generation and polyADP ribose polymers (PAR) formation, while pre-treatment with serine (Ser) before BMAA addition decreased PHR death. Notably, RXR activation with the HX630 agonist prevented BMAA-induced death in both neuronal types, reducing ROS generation, preserving mitochondrial potential, and decreasing TUNEL-positive cells and PAR formation. This suggests that BMAA promoted PHR death by substituting Ser in polypeptide chains and by inducing polyADP ribose polymerase activation. BMAA induced cell death in ARPE-19 cells, a human epithelial cell line; RXR activation prevented this death, decreasing ROS generation and caspase 3/7 activity. These findings suggest that RXR activation prevents BMAA harmful effects on retinal neurons and RPE cells, supporting this activation as a broad-spectrum strategy for treating retina degenerations.
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Diamino Aminoácidos , Toxinas de Cianobactérias , Espécies Reativas de Oxigênio , Epitélio Pigmentado da Retina , Receptores X de Retinoides , Diamino Aminoácidos/farmacologia , Animais , Ratos , Espécies Reativas de Oxigênio/metabolismo , Receptores X de Retinoides/metabolismo , Epitélio Pigmentado da Retina/metabolismo , Epitélio Pigmentado da Retina/efeitos dos fármacos , Epitélio Pigmentado da Retina/citologia , Neurônios Retinianos/metabolismo , Neurônios Retinianos/efeitos dos fármacos , Apoptose/efeitos dos fármacos , Estresse Oxidativo/efeitos dos fármacos , Humanos , Morte Celular/efeitos dos fármacosRESUMO
Inoculation of Azospirillum in maize has become a standard practice in Latin America. However, information on the behavior and population survival of the Azospirillum post-inoculation is scarce, making standardization difficult and generating variations in inoculation efficiency across assays. In this study, we tracked the colonization of three agriculturally relevant Azospirillum strains (Ab-V5, Az39, and the ammonium excreting HM053) after different inoculation methods in maize crops by qPCR. Besides, we assessed their ability to promote maize growth by measuring biometric parameters after conducting a greenhouse essay over 42 days. Inoculated plants exhibited Azospirillum population ranging from 103 to 107 cells plant-1 throughout the experiment. While all strains efficiently colonized roots, only A. argentinense Az39 demonstrated bidirectional translocation between roots and shoots, which characterizes a systemic behavior. Optimal inoculation methods for plant growth promotion varied among strains: soil inoculation promoted the best maize growth for the Ab-V5 and Az39 strains, while seed inoculation proved most effective for HM053. The findings of this study demonstrate that the inoculation method affects the behavior of Azospirillum strains and their effectiveness in promoting maize growth, thereby guiding practices to enhance crop yield.
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Azospirillum , Zea mays , Zea mays/microbiologia , Zea mays/crescimento & desenvolvimento , Azospirillum/fisiologia , Raízes de Plantas/microbiologia , Raízes de Plantas/crescimento & desenvolvimento , Microbiologia do SoloRESUMO
BACKGROUND: The nod-like receptor protein 3 (NLRP3) is one of the most characterized inflammasomes involved in the pathogenesis of several cancers, including hepatocellular carcinoma (HCC). However, the effects of genetic variants in the NLRP3 inflammasome-related genes on survival of hepatitis B virus (HBV)-related HCC patients are unclear. METHODS: We performed multivariable Cox proportional hazards regression analysis to evaluate associations between 299 single-nucleotide polymorphisms (SNPs) in 16 NLRP3 inflammasome-related genes and overall survival (OS) of 866 patients with HBV-related HCC. We further performed expression quantitative trait loci (eQTL) analysis using the data from the GTEx project and 1000 Genomes projects, and performed differential expression analysis using the TCGA dataset to explore possible molecular mechanisms underlying the observed associations. RESULTS: We found that two functional SNPs (PANX1 rs3020013 A > G and APP rs9976425 C > T) were significantly associated with HBV-related HCC OS with the adjusted hazard ratio (HR) of 0.83 [95% confidence interval (CI) = 0.73-0.95, P = 0.008], and 1.26 (95% CI = 1.02-1.55, P = 0.033), respectively. Moreover, the eQTL analysis revealed that the rs3020013 G allele was correlated with decreased mRNA expression levels of PANX1 in both normal liver tissues (P = 0.044) and whole blood (P < 0.001) in the GTEx dataset, and PANX1 mRNA expression levels were significantly higher in HCC samples and associated with a poorer survival of HCC patients. However, we did not observe such correlations for APP rs9976425. CONCLUSIONS: These results indicated that SNPs in the NLRP3 inflammasome-related genes may serve as potential biomarkers for HBV-related HCC survival, once replicated by additional larger studies.
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OBJECTIVE: High-grade gliomas are aggressive brain tumors with poor prognoses. Understanding the factors that influence their progression is crucial for improving treatment outcomes. This study investigates the prognostic significance of panimmune inflammation in patients diagnosed with high-grade gliomas. MATERIALS-METHODS: Data from 89 high-grade glioma patients were analysed retrospectively. The Panimmune inflammation Value (PIV) of each patient meeting the eligibility criteria was calculated on the basis of platelet, monocyte, neutrophil, and lymphocyte counts obtained from peripheral blood samples taken on the first day of treatment. PIV is calculated using the following formula: PIV = T × M × N ÷ L. A receiver operating characteristic (ROC) analysis was employed to identify the optimal cut-off value for PIV about progression-free survival (PFS) and overall survival (OS) outcomes. The primary and secondary endpoints were the differences in OS and PFS between the PIV groups. The KaplanâMeier method was used for survival analyses. RESULTS: The ROC analysis indicated that the optimal PIV threshold was 545.5, which exhibited a significant interaction with PFS and OS outcomes. Patients were subsequently divided into two groups based on their PIV levels: a low PIV (L-PIV) group comprising 45 patients and a high PIV (H-PIV) group comprising 44 patients. A comparative analysis of survival rates indicated that patients with elevated PIV had a shorter median PFS of 4.0 months compared to 8.0 months in the low PIV group (P = 0.797), as well as a reduced median OS of 19.0 months versus not available (NA) in the low PIV group (P = 0.215). CONCLUSION: Our study results did not reveal a statistically significant association between H-PIV measurements and reduced PFS or OS. However, PIV effectively stratified newly diagnosed high-grade glioma patients into two distinct groups with significantly different PFS and OS outcomes.
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Breast cancer (BC) is the most common cancer in women, with incidence rates increasing globally in recent years. Therefore, it is important to find new molecules with prognostic and therapeutic value to improve therapeutic response and quality of life. The polyunsaturated fatty acids (PUFAs) metabolic pathway participates in various physiological processes, as well as in the development of malignancies. Although aberrancies in the PUFAs metabolic pathway have been implicated in carcinogenesis, the functional and clinical relevance of this pathway has not been well explored in BC. To evaluate the clinical significance of soluble epoxide hydrolase (EPHX2) expression in Mexican patients with BC using tissue microarrays (TMAs) and digital pathology (DP). Immunohistochemical analyses were performed on 11 TMAs with 267 BC samples to quantify this enzyme. Using DP, EPHX2 protein expression was evaluated solely in tumor areas. The association of EPHX2 with overall survival (OS) was detected through bioinformatic analysis in public databases and confirmed in our cohort via Cox regression analysis. Clear nuclear expression of EPHX2 was identified. Receiver operating characteristics (ROC) curves revealed the optimal cutoff point at 2.847062 × 10-3 pixels, with sensitivity of 69.2% and specificity of 67%. Stratification based on this cutoff value showed elevated EPHX2 expression in multiple clinicopathological features, including older age and nuclear grade, human epidermal growth factor receptor 2 (HER2) and triple negative breast cancer (TNBC) subtypes, and recurrence. Kaplan-Meier curves demonstrated how higher nuclear expression of EPHX2 predicts shorter OS. Consistently, multivariate analysis confirmed EPHX2 as an independent predictor of OS, with a hazard ratio (HR) of 3.483 and a 95% confidence interval of 1.804-6.724 (p < 0.001). Our study demonstrates for the first time that nuclear overexpression of EPHX2 is a predictor of poor prognosis in BC patients. The DP approach was instrumental in identifying this significant association. Our study provides valuable insights into the potential clinical utility of EPHX2 as a prognostic biomarker and therapeutic target in BC.
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Biomarcadores Tumorais , Neoplasias da Mama , Epóxido Hidrolases , Humanos , Epóxido Hidrolases/metabolismo , Epóxido Hidrolases/genética , Feminino , Neoplasias da Mama/patologia , Neoplasias da Mama/metabolismo , Neoplasias da Mama/mortalidade , Neoplasias da Mama/genética , Pessoa de Meia-Idade , Prognóstico , Biomarcadores Tumorais/metabolismo , Idoso , Adulto , Núcleo Celular/metabolismo , Regulação para Cima , Regulação Neoplásica da Expressão Gênica , Curva ROC , Idoso de 80 Anos ou mais , Estimativa de Kaplan-MeierRESUMO
Background: Diffuse intrinsic pontine glioma (DIPG) stands as the predominant type of brainstem glioma. It is characterized by a notably brief median survival period, with the majority of patients experiencing disease progression within six months following radiation therapy. This systematic review and meta-analysis aims to assess the efficacy and safety of hypofractionated radiotherapy (HFRT) compared to conventionally fractionated radiotherapy (CFRT) in DIPG treatment. Materials and methods: A systematic literature search was conducted in four databases, and relevant studies comparing HFRT and CFRT in DIPG were included. Data were extracted and analyzed for overall survival (OS), progression-free survival (PFS), and treatment-related toxicities. Statistical analysis was performed using random-effects models with heterogeneity assessment. Results: Five studies met the inclusion criteria, comprising 518 patients. No significant difference in one-year OS was observed between HFRT and CFRT (29% vs. 22%, p = 0.94). The median OS was similar in both treatment groups (9.7 vs. 9.3 months, p = 0.324). Similarly, no significant difference in one-year PFS was found between HFRT and CFRT (19.8% vs. 16.6%, p = 0.82), with comparable median PFS (9.3 vs. 9.4 months, p = 0.20). In meta-regression analysis, there was no association of chemotherapy (p > 0.05) or radiation biologically effective dose (BED) (p > 0.05) regarding OS or PFS outcomes. There were no significant differences in treatment-related toxicities. Conclusions: HFRT yields one-year OS and PFS rates similar to CFRT in DIPG, with no significant differences in treatment-related toxicities. Chemotherapy and BED did not affect OS or PFS.
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This study developed and evaluated chitosan-sodium alginate capsules containing the probiotic Lacticaseibacillus rhamnosus GG using extrusion and emulsification techniques. The encapsulated L. rhamnosus GG cells were also evaluated for technological and probiotic-related physiological functionalities, as well as when incorporated in UHT and powdered milk. Extrusion (86.01 ± 1.26%) and emulsification (74.43 ± 1.41%) encapsulation techniques showed high encapsulation efficiency and high survival rates of L. rhamnosus GG during 28 days of refrigeration and room temperature storage, especially emulsification capsules (> 81%). The encapsulated L. rhamnosus GG cells showed high survival rates during exposure to simulated gastrointestinal conditions (72.65 ± 1.09-114.15 ± 0.44%). L. rhamnosus GG encapsulated by extrusion and emulsification performed satisfactorily in probiotic-related physiological (pH and bile salts tolerance) and technological properties (positive proteolytic activity, diacetyl and exopolysaccharides production, high NaCl tolerance (> 91%), besides having high heat tolerance (> 76%)). L. rhamnosus GG in extrusion and emulsification capsules had high survival rates (> 89%) and did not significantly affect physicochemical parameters in Ultra-High Temperature (UHT) and powdered milk during storage. The results demonstrate that L. rhamnosus GG can be successfully encapsulated with alginate-chitosan as a protective material through extrusion and emulsification techniques. UHT and powdered milk could serve as appropriate delivery systems to increase the intake of this encapsulated probiotic by consumers.
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Objective: Real-world data for patients with endometrial cancer (EC) are limited, particularly in Latin America. We present treatment pattern findings from ECHOS-A - Endometrial Cancer Health Outcomes Study in Argentina. Materials and methods: A retrospective study using clinical data from privately insured patients with EC diagnosed from 2010 to 2019. Index (diagnosis proxy) was first date of an EC-related health term or treatment. Demographics, clinical characteristics, and FIGO staging were described. Disease progression and survival were assessed until study end, loss to follow-up, or death. Results: Of 805 patients with EC, 77.4 % (n = 623/805) received any treatment and 22.6 % (n = 182/805) received none. Among those treated, 31.8 % (n = 198/623) had first-line (1L) systemic therapy, and 45.5 % (n = 90/198) proceeded to second-line (2L) therapy. Mean follow-up was 33.6 (SD 31.8) months. Of those receiving any treatment, 87.3 % (n = 544/623) had FIGO stage data (I, 62.9 %; II, 18.6 %; III, 13.6 %; IV, 5.0 %). Treatment by class in 1L and 2L, respectively, were platinum chemotherapy, 73.7 %, 36.7 %; non-platinum chemotherapy, 73.7 %, 62.2 %; immunotherapy, 1.0 %, 11.1 %; hormone therapy, 17.7 %, 26.7 %. Carboplatin/paclitaxel was the most frequent 1L (52.5 %) and 2L (14.4 %) regimen. Mean time to progression was 14.1 (SD 16.3) and 8.8 (SD 8.3) months in 1L and 2L, respectively. Adjusted 1- to 5-year risk of progression/death was 46.5-77.5 % and 65.0-86.2 % in 1L and 2L, respectively. Conclusions: Approximately one-quarter of patients with EC received no treatment, and approximately two-thirds were not treated with 1L systemic therapy. Efforts to better understand the reasons for these treatment patterns are crucial for improving patient outcomes.
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Introduction Gastric cancer is a significant major global health concern, particularly prevalent in Asia. In recent years, a large number of new cases have been diagnosed worldwide, leading to a substantial number of deaths. The disease tends to present more aggressively in these cases, leading to debates about the prognosis and survival outcomes. Nonetheless, research has shown that survival rates improve significantly when the tumor is completely surgically resected. Materials and methods This retrospective study included patients between 16 and 45 years old, diagnosed with gastric cancer, with the support of the pathology department, who underwent surgery in the upper GI service, in the period from January 2006 to December 2012. Data collected encompassed variables such as gender, age, tumor size, type of surgery, overall survival, disease-free period, type and histological degree of the tumor, clinical stage of the cancer, and R0 resection (curative resection). All patients with a confirmed diagnosis of gastric cancer were included and treated with surgery and D1 limited dissection or extended D2 dissection. Patients who have received chemotherapy prior to surgical treatment and those who have been surgically treated outside the XXI Century National Medical Center were excluded. Results A total of 104 patients were included; the predominant histological type was diffuse adenocarcinoma accounting for 79.8% and 81.7% of the cases were histological grade 3. The most common clinical stage was IIIA in 41.3% of the cases. In 53.8% of the cases, we obtained an R0 resection. D2 lymphadenectomy was performed in 53.8% of the cases, with an overall survival rate of 82.69%. Significant prognostic factors for survival included T4 depth with an increase in risk for mortality (OR: 25.93; 95% CI: 6.41-53.54; p=0.001), lymph node status (OR: 14.76; 95% CI: 4.6-46.83; p<0.001), and size greater than 5 cm (OR: 1.8; 95% CI: 0.61-6.35; p<0.001). Conclusions Gastric cancer is more common in adults aged above 60 years old, but the incidence in young adults under 45 years old has been increasing. Although young gastric cancer patients present with more aggressive tumor behavior, these patients can have similar or even better overall survival compared to older patients, being 35% in some cases, especially in the resectable setting. Further research is still needed to fully characterize the unique biology and optimal management of gastric cancer in young adults.
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BACKGROUND: Worldwide, vegan and vegetarian lifestyles, as well as food allergies and intolerance (e.g. lactose intolerance and milk protein allergy) demand the development of alternatives to dairy-based probiotic foods. In the present study, probiotic Lacticaseibacillus casei CECT 9104 was added to alginate-based edible coatings enriched with inulin and oligofructose and applied to fresh-cut apple. Microbiological, physicochemical and sensory quality parameters of the apple cubes were monitored during 8 days of refrigerated storage. Lacticaseibacillus casei was tested for its antagonistic effect against inoculated Listeria innocua and Escherichia coli O157:H7. The viability of the probiotic strain during refrigerated storage and after simulated gastrointestinal digestion (GID) was evaluated. RESULTS: After 8 days of storage, 9.52-9.64 log colony-forming units (CFU) g-1 of L. casei were detected in apple samples. The functional apple cubes retained 8.31-8.43 log CFU g-1 of the probiotic after GID, without a significant effect of prebiotic addition. The microbiological quality and nutritional properties were maintained by the use of active coatings, whereas the sensory quality decreased after 8 days of storage. A bactericidal effect was exerted by the probiotic strain loaded in the coating against L. innocua artificially inoculated on apple cubes. Escherichia coli O157:H7 counts were reduced by 2.5 log after 8 days. CONCLUSION: This study has demonstrated the suitability of apple cubes as an alternative matrix to milk for carrying probiotic L. casei CECT 9104 and prebiotics, offering a promising alternative for the development of plant-based functional foods. © 2024 Society of Chemical Industry.
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Prognostic factors for local recurrence in patients with rectal cancer submitted to neoadjuvant chemoradiotherapy and total mesorectal excision. BACKGROUND: The standard curative treatment for locally advanced rectal cancer of the middle and lower thirds is long-course chemoradiotherapy followed by total mesorectal excision. PURPOSE: To evaluate the prognostic factors associated with local recurrence in patients with rectal cancer submitted to neoadjuvant chemoradiotherapy and total mesorectal excision. METHODS: Retrospective study including patients with rectal cancer T3-4N0M0 or T (any)N + M0 located within 10 cm from the anal border, or patients with T2N0M0 located within 5 cm, treated by long course chemoradiotherapy followed by total mesorectal excision with curative intent. Clinical, demographic, radiologic, surgical, and anatomopathological data were collected. Local recurrence was estimated using the Kaplan-Meier function, and risk was estimated according to each characteristic using univariate and multivariate analyses. RESULTS: 270 patients were included, 57.8% male and mean age 61.7 (30â88) years. At initial staging, 6.7% of patients were stage I, 21.5% stage II, and 71.8% stage III. Open surgery was performed in 65.2%, with sphincter preservation in 78.1%. Mortality within 30 postoperative days was 0.7%. After 49.4 (0.5â86.1) months of median follow-up, overall and local recurrences were 26.3% and 5.9%. On multivariate analyses, local recurrence was associated with involvement of the mesorectal fascia on restaging MRI (HR = 9.11, p = 0.001) and with pathologic involvement of radial surgical margin (HR = 8.19, p < 0.001). CONCLUSION: Local recurrence of rectal cancer treated with long-course chemoradiation and total mesorectal excision is low and is associated with pathologic involvement of the radial surgical margin and can be predicted on restaging MRI.
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Terapia Neoadjuvante , Recidiva Local de Neoplasia , Neoplasias Retais , Humanos , Neoplasias Retais/terapia , Neoplasias Retais/patologia , Neoplasias Retais/cirurgia , Masculino , Feminino , Pessoa de Meia-Idade , Estudos Retrospectivos , Idoso , Adulto , Terapia Neoadjuvante/métodos , Prognóstico , Idoso de 80 Anos ou mais , Estadiamento de Neoplasias , Fatores de Risco , Resultado do Tratamento , Quimiorradioterapia , Estimativa de Kaplan-Meier , Fatores de TempoRESUMO
BACKGROUND: Perioperative blood transfusion (BT) is frequent in the treatment of gastric cancer (GC), but its effects on the prognosis of GC remains controversial. In this study, we aimed to further confirm the relationship of perioperative BT with GC overall survival and to evaluate the predictive value of microRNA-338-3p (miR-338-3p) for the prognosis of GC patients who received perioperative BT. METHODS: Clinical data and serum samples were collected and analyzed from 246 patients with GC. Five-year follow-up survival information was assessed by Kaplan-Meier survival analysis. miR-338-3p relative expression was assessed by RT-qPCR, and its relationship with the prognosis of GC patients, who received perioperative BT, was evaluated using Kaplan-Meier curves and Cox regression analysis. RESULTS: GC patients received perioperative BT had poor 5 year survival than those without BT. In patients received BT, miR-338-3p expression was higher in survival cases than died population and high miR-338-3p was independently associated with better overall survival prognosis. CONCLUSION: Perioperative BT is related with poor prognosis in GC patients and miR-338-3p may be a prognostic biomarker for GC patients received perioperative BT. BT in perioperative GC patients should be cautious, especially for those with low levels of miR-338-3p.
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Objective: To evaluate the profile and survival of patients diagnosed with Myasthenia Gravis, by reviewing medical records of neurological consultations at a referral service in the interior of Pará (Brazil), between 2005 and 2020. Methods: a historical, observational and retrospective cohort study. 36 participants were included. Survival analysis methods were used to identify prognostic factors for disease remission at the observation time of 36 months. The correlation between the variables and the death outcome was performed using the chi-square test. Results: Most patients were women (66.6%) and had the generalized form of the disease (86.1%). The most prevalent symptoms were: ophthalmoparesis (97.2%), fatigability (75%) and dysphagia (72.2%). Among the complications, 19.4% had myasthenic crisis. The dosage of antiacetylcholine receptor (AChR) antibody was positive in 58.3% and 69.4% underwent electroneuromyography, and 72% of them had electrodecrement. Most of the patients responded to the staggered standard treatment and achieved remission (83.3%), while 16.6% died. Survival analysis showed through Kaplan-Meier curves and Log-rank test that the variables related to poor control were male gender (p=0.01), thymus disease (p=0.02) and use of cyclosporine (p=0.02). The factors that influenced the death outcome were male gender, cyclosporine and thymectomy. Conclusion: The study showed that the evolution of people with Myasthenia Gravis over 15 years and the poor prognostic factors were equivalent to the international literature.
Objetivo: Avaliar o perfil e a sobrevida de pacientes com diagnóstico de Miastenia Gravis, por meio da revisão de prontuários de consultas neurológicas em um serviço de referência no interior do Pará (Brasil), entre 2005 e 2020. Métodos: estudo de coorte histórico, observacional e retrospectivo. 36 participantes foram incluídos. Métodos de análise de sobrevivência foram utilizados para identificar fatores prognósticos para remissão da doença no período de observação de 36 meses. A correlação entre as variáveis e o desfecho de óbito foi realizada por meio do teste qui-quadrado. Resultados: A maioria dos pacientes eram mulheres (66,6%) e apresentavam a forma generalizada da doença (86,1%). Os sintomas mais prevalentes foram: oftalmoparesia (97,2%), fadiga (75%) e disfagia (72,2%). Dentre as complicações, 19,4% tiveram crise miastênica. A dosagem do anticorpo anti-receptor de acetilcolina (AChR) foi positiva em 58,3% e 69,4% realizaram eletroneuromiografia, sendo que 72% deles apresentaram eletrodecremento. A maioria dos pacientes respondeu ao tratamento padrão escalonado e obteve remissão (83,3%), enquanto 16,6% morreram. A análise de sobrevivência mostrou através de curvas de Kaplan-Meier e teste Log-rank que as variáveis relacionadas ao mau controle foram sexo masculino (p=0,01), doença do timo (p=0,02) e uso de ciclosporina (p=0,02). Os fatores que influenciaram no desfecho óbito foram sexo masculino, ciclosporina e timectomia. Conclusão: O estudo mostrou que a evolução das pessoas com Miastenia Gravis ao longo de 15 anos e os fatores de mau prognóstico foram equivalentes à literatura internacional.
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Traditionally, lobectomy was standard for stage IA non-small-cell lung cancer (NSCLC). Recent RCTs suggest sublobar resection's comparable outcomes. Our meta-analysis, incorporating 30 studies (including four RCTs), assessed sublobar resection's efficacy. Employing a random-effects model and I2 statistics for heterogeneity, we found sublobar resection reduced DFS (HR 1.31, p < 0.01) and OS (HR 1.27, p < 0.01) overall. However, RCT subgroup analysis showed no significant differences in DFS (p = 0.28) or OS (p = 0.62). Sublobar resection is a viable option for well-selected patients.
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Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Pneumonectomia , Humanos , Carcinoma Pulmonar de Células não Pequenas/cirurgia , Carcinoma Pulmonar de Células não Pequenas/patologia , Carcinoma Pulmonar de Células não Pequenas/mortalidade , Neoplasias Pulmonares/cirurgia , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/mortalidade , Pneumonectomia/métodos , Pneumonectomia/mortalidade , Estadiamento de Neoplasias , Taxa de SobrevidaRESUMO
Social insect pests, particularly leaf-cutting ants, present a considerable challenge in terms of control. Leaf-cutting ants are significant agricultural, forestry, and pasture pests, and understanding their behavior and defense mechanisms is essential for managing their colonies effectively. While toxic ant baits are a primary control method, the limited availability of effective insecticides and concerns over their hazardous nature has spurred the search for alternative solutions, particularly natural compounds, which aligns with the goals of forest certification groups. In the light of previous evidence demonstrating the efficacy of nasturtium leaves (Tropaeolum majus L. (Brassicales: Tropaeolaceae)) in suppressing leaf-cutting ant colonies, this study investigates 2 active components of nasturtium leaf extracts: diphenyl disulfide and lyral. We tested their impact on Atta sexdens (L.) (Hymenoptera: Formicidae), the most prevalent leaf-cutter ant species in Brazil, and their symbiotic fungus, Leucoagaricus gongylophorus (Möller) Singer (Agaricales: Agaricaceae). We conducted experiments with increasing concentrations of diphenyl disulfide and lyral, assessing their effects on the symbiotic fungus and on forager workers and gardeners of A. sexdens colonies. Our findings revealed no fungicidal activity, and ant mortality was minimal in both topical and ingestion bioassays with the exception of gardeners topically exposed to diphenyl sulfide. Furthermore, the compounds did not affect leaf ingestion, but diphenyl disulfide did increase interactions among foragers. These results suggest that neither diphenyl disulfide nor lyral are the primary contributors to the suppression of leaf-cutting ant colonies by nasturtium leaves. However, they may enhance the formicidal activity of other compounds present in nasturtium leaves.
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Formigas , Inseticidas , Folhas de Planta , Animais , Simbiose , Controle de Insetos , Extratos Vegetais/farmacologiaRESUMO
BACKGROUND: Phospholipase A2 (PLA2) is a large family of enzymes involved in the inflammatory process that catalyzes the hydrolysis of membrane phospholipids, leading to the production of free fatty acids and lysophospholipids, starting the arachidonic acid cascade. Their expression has been related to the behavior of several cancers. Our objective is to search for PLA2 expression in prostate cancer (PCa) tissue that correlates with prognosis and survival. METHODS: Using qRT-PCR, we analyzed the expression levels of PLA2G1B, PLA2G2A, PLA2G2D, PLA2G4A, PLA2G4B, PLA2G4C, PLA2G4D, PLA2G4E, PLA2G4F, PLA2G6, PLA2G7, PLA2G16, PNPLA1, and PNPLA2 in PCa tissue from 108 patients submitted to radical prostatectomy, followed by a mean time of 163 months. RESULTS: All PLA2 was overexpressed in PCa compared to normal tissue. Interestingly, higher expression of some PLA2 was related to favorable prognostic factors: lower levels of PSA (PLA2G2A, PLA2G4D), lower rates of lymph node metastasis (PLA2G16 and PLA2G1B), and organ-confined disease (PLA2G4A). Most importantly, PLAG4B was independently related to longer disease-free survival. CONCLUSION: This is the first study exploring comprehensively the expression levels of PLA2 in PCa, showing that the higher expression of some PLA2 should be used as biomarkers of good prognosis and longer disease-free survival.
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Biomarcadores Tumorais , Fosfolipases A2 , Neoplasias da Próstata , Humanos , Masculino , Neoplasias da Próstata/genética , Neoplasias da Próstata/patologia , Prognóstico , Biomarcadores Tumorais/metabolismo , Idoso , Fosfolipases A2/genética , Pessoa de Meia-Idade , Seguimentos , Fatores de Tempo , Taxa de SobrevidaRESUMO
Parkinson's disease (PD) is the second most prevalent neurodegenerative disorder worldwide, and the therapeutic is focused on several approaches including the inhibition of fibril formation by small compounds, avoiding the formation of cytotoxic oligomers. Thus, we decided to explore the capacity of compounds carrying catechol moieties to inhibit the progression of α-synuclein. Overall, the compounds rosmarinic acid (1), carnosic acid (2), carnosol (3), epiisorosmanol (4), and rosmanol (5) avoid the progression of fibril formation assessed by Thiofavine T (ThT), and atomic force microscopy images showed that morphology is influenced for the actions of compounds over fibrillization. Moreover, ITC experiments showed a Kd varying from 28 to 51 µM, the ΔG showed that the reaction between compounds and α-syn is spontaneous, and ΔH is associated with an exothermic reaction, suggesting the interactions of hydrogen bonds among compounds and α-syn. Docking experiments reinforce this idea showing the intermolecular interactions are mostly hydrogen bonding within the sites 2, 9, and 3/13 of α-synuclein, and compounds 1 and 5. Thus, compound 1, rosmarinic acid, interestingly interacts better with site 9 through catechol and Lysines. In cultured Raw 264. 7 cells, the presence of compounds showed that most of them can promote cell differentiation, especially rosmarinic acid, and rosmanol, both preserving tubulin cytoskeleton. However, once we evaluated whether or not the aggregates pre-treated with compounds could prevent the disruption of microtubules of Raw 264.7 cells, only pre-treated aggregates with rosmarinic acid prevented the disruption of the cytoskeleton. Altogether, we showed that especially rosmarinic acid not only inhibits α-syn but stabilizes the remaining aggregates turning them into not-toxic to Raw 264.7 cells suggesting a main role in cell survival and antigen processing in response to external α-syn aggregates.