To evaluate the functional results after the use of extracorporeal shockwave therapy (ESWT) in four groups of patients: tendinopathy, partial rotator cuff injury, adhesive capsulitis and calcareous ...tendinopathy of the rotator cuff at one month and three months after the end of treatment.
Case series in which patients were evaluated according to the VAS of pain, range of motion of the shoulder, and functional questionnaires DASH and modified UCLA.
There was a significant increase in the measure of flexion, lateral rotation and shoulder abduction in the evaluations after treatment in relation to the baseline measurement (p < 0.001) and no evidence of significant difference was found between the post-treatment evaluations at one month and three months follow-up (p > 0.05). There was a significant reduction in the VAS score, increase in the UCLA score and a significant reduction in the DASH score in the post-treatment evaluations in relation to the baseline score (p < 0.001) and a significant improvement in the three-month evaluation in relation to one month (p < 0.05).
Extracorporeal shockwave therapy proved to be efficient and safe in the treatment of shoulder pathologies, improving pain, range of motion and functional scores in all groups of patients evaluated in the study.
Abstract Structural alterations in the limbic system, neuronal cell loss, and low levels of neurotrophins have been implicated in the pathogenesis of depression. While it is generally accepted that ...increasing monoamine levels in the brain can effectively alleviate depression, the precise neurobiological mechanisms involved are unclear. In the present study, we examined the effects of two antidepressants, duloxetine and mirtazapine, on the expression of apoptotic and neurotrophic proteins in the cerebral cortex and hippocampus of mice. Duloxetine (10 mg/kg) and mirtazapine (3 mg/kg) were chronically administered for 21 days, and qRT-PCR analysis was carried for the following: neurotrophins (BDNF, NGF, FGF-2, and NT-3); anti-apoptotic proteins (Bcl-2 and Bcl-xL) and pro-apoptotic proteins (Bax, Bad, and p53). Both duloxetine and mirtazapine produced antidepressant activity in the forced swimming test and induced increased cortical and hippocampal mRNA expression of BDNF. Duloxetine also increased Bcl-2, Bcl-xL, FGF-2, and NT-3 expression in the cerebral cortex, and FGF-2 expression in the hippocampus. Moreover, duloxetine reduced Bax and p53 expression in the hippocampus, and Bad expression in the cerebral cortex. Mirtazapine decreased Bcl-xL and Bax expression in the hippocampus, and Bad and p53 expression in both the hippocampus and cerebral cortex. Mirtazapine also increased the expression of neurotrophins, NGF and NT-3, in the cerebral cortex. These results suggest that duloxetine and mirtazapine could elicit their therapeutic effect by modulating the activity of apoptotic and neurotrophic pathways, thus enhancing plasticity and cell survival in depressive patients.
Ewing sarcoma (ES) is an aggressive form of bone/soft tissue cancer, and it is the second most frequent tumor in children and young adults, being very rare in jawbones. The aims of the present study ...are to emphasize the radiographic features of ES affecting the mandible and discuss the main differential diagnosis. A 7-year-old boy presented with a growth in the chin region with 2 months’ of duration. Tomography showed a poorly delimited osteolytic lesion affecting the anterior region of the mandible, which caused tooth displacement. Moreover, periosteal reaction called sunburst phenomenon and moth-eaten aspect were also observed. Incisional biopsy was performed, and histopathologic and immunohistochemical features were consistent of ES. Treatment consisted of 14 chemotherapy cycles, resection of the anterior region of the mandible, and reconstruction with a fibula free flap. The patient is asymptomatic after 1 year from the surgery, and there is no evidence of local/systemic diseases.
This work reports kinetic and equilibrium studies of cadmium(II) and lead(II) adsorption by the brown seaweed
Cystoseira baccata. Kinetic experiments demonstrated rapid metal uptake. Kinetic data ...were satisfactorily described by a pseudo-second order chemical sorption process. Temperature change from 15 to 45
°C showed small variation on kinetic parameters. Langmuir–Freundlich equation was selected to describe the metal isotherms and the proton binding in acid–base titrations. The maximum metal uptake values were around 0.9
mmol
g
−1 (101 and 186
mg
g
−1 for cadmium(II) and lead(II), respectively) at pH 4.5 (raw biomass), while the number of weak acid groups were 2.2
mmol
g
−1 and their proton binding constant,
K
H, 10
3.67 (protonated biomass). FTIR analysis confirmed the participation of carboxyl groups in metal uptake. The metal sorption was found to increase with the solution pH reaching a plateau above pH 4. Calcium and sodium nitrate salts in solution were found to affect considerably the metal biosorption.
Marine macroalgae show promise for biosorption of lead and cadmium.
Residential dust is recognized as a major source of environmental contaminants, including polycyclic aromatic hydrocarbons (PAHs) and plasticizers, such as phthalic acid esters (PAEs). A sampling ...campaign was carried out to characterize the dust fraction of particulate matter with an aerodynamic diameter smaller than 10 µm (PM10), using an in situ resuspension chamber in three rooms (kitchen, living room, and bedroom) of four Spanish houses. Two samples per room were collected with, at least, a one-week interval. The PM10 samples were analyzed for their carbonaceous content by a thermo-optical technique and, after solvent extraction, for 20 PAHs, 8 PAEs and one non-phthalate plasticizer (DEHA) by gas chromatography-mass spectrometry. In general, higher dust loads were observed for parquet flooring as compared with tile. The highest dust loads were obtained for rugs. Total carbon accounted for 9.3 to 51 wt% of the PM10 mass. Plasticizer mass fractions varied from 5 µg g−1 to 17 mg g−1 PM10, whereas lower contributions were registered for PAHs (0.98 to 116 µg g−1). The plasticizer and PAH daily intakes for children and adults via dust ingestion were estimated to be three to four orders of magnitude higher than those via inhalation and dermal contact. The thoracic fraction of household dust was estimated to contribute to an excess of 7.2 to 14 per million people new cancer cases, which exceeds the acceptable risk of one per million.
RESUMO Objetivo: fístula anastomótica (FA) após colectomia para câncer colorretal (CCR) é complicação grave. Esta revisão sistemática e meta-análise avaliou os fatores de risco pré-operatórios para ...FA em pacientes submetidos à colectomia. Métodos: a pesquisa bibliográfica abrangeu 15 anos e 9 meses (1 de janeiro de 2005 - 19 de outubro de 2020), sendo utilizadas as plataformas PubMed, Cochrane Library, Scopus, Biblioteca Virtual em Saúde, Europe PMC e Web of Science. O critério de inclusão foram estudos transversais, coorte e caso-controle em fatores de risco pré-operatórios para FA (desfecho). A escala Newcastle-Ottawa foi usada para avaliação de viés dos estudos. A metanálise envolveu o cálculo dos efeitos de tratamento para cada estudo individualmente incluindo odds ratio (OR), risco relativo (RR) e intervalo de confiança de 95% (IC95%) com construção de modelo de efeitos aleatórios, para avaliar o impacto de cada variável (p<0,05). Resultados: foram selecionados 39 estudos transversais, 21 coortes e quatro casos-controle. A metanálise identificou 14 fatores de risco para FA em pacientes com CCR após colectomia, que são sexo masculino (RR=1,56; IC 95%=1,40-1,75), tabagismo (RR=1,48; IC 95%=1,30-1,69), alcoolismo (RR=1,35; IC 95%=1,21-1,52), diabetes mellitus (RR=1,97; IC 95%=1,44-2,70), doenças pulmonares (RR=2,14; IC 95%=1,21-3,78), doença pulmonar obstrutiva crônica (RR=1,10; IC 95%=1,04-1,16), doença coronariana (RR=1,61; IC 95%=1,07-2,41), doença renal crônica (RR=1,34; IC 95%=1,22-1,47), altas notas na escala ASA (RR=1,70; IC 95%=1,37-2,09), cirurgia abdominal prévia (RR=1,30; IC 95%=1,04-1,64), cirurgia de emergência (RR=1,61; IC 95%=1,26-2,07), quimioterapia neoadjuvante (RR=2,16; IC 95%=1,17-4,02), radioterapia (RR=2,36; IC 95%=1,33-4,19) e quimiorradioterapia (RR=1,58; IC 95%=1,06-2,35). Conclusões: importantes fatores de risco pré-operatórios para FA colorretais em pacientes com CCR foram identificados com base nas melhores pesquisas baseadas em evidências e esse conhecimento deve influenciar decisões relacionadas ao tratamento.
ABSTRACT Introduction: anastomotic leak (AL) after colectomy for colorectal cancer (CRC) is a life-threatening complication. This systematic review and meta-analysis aimed to evaluate the preoperative risk factors for AL in patients submitted to colectomy. Methods: the bibliographic search covered 15 years and 9 months, from 1st January 2005 to 19th October 2020 and was performed using PubMed, Cochrane Library, Scopus, Biblioteca Virtual em Saúde, Europe PMC and Web of Science databases. The inclusion criteria were cross-sectional, cohort and case-control studies on preoperative risk factors for AL (outcome). The Newcastle-Ottawa scale was used for bias assessment within studies. Meta-analysis involved the calculation of treatment effects for each individual study including odds ratio (OR), relative risk (RR) and 95% confidence intervals (95% CI) with construction of a random-effects model to evaluate the impact of each variable on the outcome. Statistical significance was set at p<0.05. Results: cross-sectional studies were represented by 39 articles, cohort studies by 21 articles and case-control by 4 articles. Meta-analysis identified 14 main risk factors for AL in CRC patients after colectomy, namely male sex (RR=1.56; 95% CI=1.40-1.75), smoking (RR=1.48; 95% CI=1.30-1.69), alcohol consumption (RR=1.35; 95% CI=1.21-1.52), diabetes mellitus (RR=1.97; 95% CI=1.44-2.70), lung diseases (RR=2.14; 95% CI=1.21-3.78), chronic obstructive pulmonary disease (RR=1.10; 95% IC=1.04-1.16), coronary artery disease (RR=1.61; 95% CI=1.07-2.41), chronic kidney disease (RR=1.34; 95% CI=1.22-1.47), high ASA grades (RR=1.70; 95% CI=1.37-2.09), previous abdominal surgery (RR=1.30; 95% CI=1.04-1.64), CRC-related emergency surgery (RR=1.61; 95% CI=1.26-2.07), neoadjuvant chemotherapy (RR=2.16; 95% CI=1.17-4.02), radiotherapy (RR=2.36; 95% CI=1.33-4.19) and chemoradiotherapy (RR=1.58; 95% CI=1.06-2.35). Conclusions: important preoperative risk factors for colorectal AL in CRC patients have been identified based on best evidence-based research, and such knowledge should influence decisions regarding treatment.
A 16-year-old female patient complaining of a maxillary mass with 6-month duration, causing asymmetry, spontaneous bleeding, and feeding difficulty presented at intraoral examination a large ...erythematous and ulcerated pedunculated mass arising from the expanded maxilla. The anterior mandible was also enlarged but covered by normal oral mucosa. Anamnesis included primary hyperparathyroidism with parathyroidectomy in the past 6 months. Panoramic x-ray showed a radiolucent and mixed area in the maxilla and anterior mandible associated with tooth displacement and resorption. Incisional biopsy of the pedunculated mass in maxilla was performed to improve the patient´s quality of life, and histologic examination revealed a proliferation of ovoid to fusiform cells accompanied by numerous multinucleated giant cells, confirming the hypothesis of central giant cell granuloma, precisely, brown tumor. Brown tumors rarely involve maxilla and can behave aggressively, and the excision of parathyroid lesions results in controlled serum levels leading to a gradual decrease in the maxillary tumors.
Despite recent advances in treatment, multiple myeloma (MM) remains an incurable malignancy. By using in vitro, ex vivo and in vivo approaches, we have identified here that lipid rafts constitute a ...new target in MM. We have found that the phospholipid ether edelfosine targets and accumulates in MM cell membrane rafts, inducing apoptosis through co-clustering of rafts and death receptors. Raft disruption by cholesterol depletion inhibited drug uptake by tumor cells as well as cell killing. Cholesterol replenishment restored MM cell ability to take up edelfosine and to undergo drug-induced apoptosis. Ceramide addition displaced cholesterol from rafts, and inhibited edelfosine-induced apoptosis. In an MM animal model, edelfosine oral administration showed a potent in vivo antimyeloma activity, and the drug accumulated preferentially and dramatically in the tumor. A decrease in tumor cell cholesterol, a major raft component, inhibited the in vivo antimyeloma action of edelfosine and reduced drug uptake by the tumor. The results reported here provide the proof-of-principle and rationale for further clinical evaluation of edelfosine and for this raft-targeted therapy to improve patient outcome in MM. Our data reveal cholesterol-containing lipid rafts as a novel and efficient therapeutic target in MM, opening a new avenue in cancer treatment.
ABSTRACT
Background:
The Alberta Stroke Program Early CT Score (ASPECTS) scale was developed for monitoring early ischemic changes on CT, being associated with clinical outcomes. The ASPECTS can also ...associate with peripheral biomarkers that reflect the pathophysiological response of the brain to the ischemic stroke.
Objective:
To investigate the association between peripheral biomarkers with the Alberta Stroke Program Early CT Score (ASPECTS) in individuals after ischemic stroke.
Methods:
Patients over 18 years old with acute ischemic stroke were enrolled in this study. No patient was eligible for thrombolysis. The patients were submitted to non-contrast CT in the first 24 hours of admission, being the Alberta Stroke Program Early CT Score and clinical and molecular evaluations applied on the same day. The National Institutes of Health Stroke Scale (NIHSS), modified Rankin scale and the Mini-Mental State Examination for clinical evaluation were also applied to all subjects. Plasma levels of BDNF, VCAM-1, VEGF, IL-1β, sTNFRs and adiponectin were determined by ELISA.
Results:
Worse neurological impairment (NIHSS), cognitive (MEEM) and functional (Rankin) performance was observed in the group with changes in the NCTT. Patients with NCTT changes also exhibited higher levels of IL-1β and adiponectin. In the linear multivariate regression, an adjusted R coefficient of 0.515 was found, indicating adiponectin and NIHSS as independent predictors of ASPECTS.
Conclusion:
Plasma levels of adiponectin are associated with the ASPECTS scores.
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