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Comparative Study of Gleason 7 (3+4) and (4+3) Prostatic Adenocarcinomas with Prognostic Criteria and Immunohistochemical Profiles of AMACR, PSA and Ki-67
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Osório, Clarice F. E. M.

; Costa, Waldemar S. Gallo, Carla B. M. Favorito, Luciano A. Sampaio, Francisco J. B.

International braz j urol

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2025, Volume 51 N. 1 elocation e20249922

Abstract: En | Text: En | PDF: En

ABSTRACT Background: To compare Gleason 7 (3+4) and (4+3) prostatic adenocarcinoma (PC) with different prognostic criteria through immunohistochemical analysis with anti-PSA, anti-Ki 67 and anti-AMARC antibodies. Methods: We analyzed 221 surgical specimens from patients between 40 and 86 years-old (mean=63) with PC. The immunohistochemical study was performed with anti-PSA, anti-Ki 67 and anti-AMARC. The microscopic fields were photographed with an Olympus DP70 digital camera coupled to an Olympus BX51 microscope and archived in TIFF. Proportion and intensity criteria were used to quantify the anti-PSA antibody and for the anti-Ki 67 antibody, the quantification by similarity of this antibody in breast carcinomas. Anti-AMACR protein expression was based on four scores: negative, weak, moderate and strong. The statistical analysis was performed with the Graph Pad Prism 5 program. Results: In the Gleason score 7 (3+4) we had 91.72% in pT2 and 8.27% in the pT3 group; 8.27% recurrences, of which 90.90% in the pT2 group. In the Gleason score 7 (4+3) we had 77.27% in the pT2 group and 22.72% in the pT3 group and 10.22% of relapses, of which 66.66% in the pT2 group and 33.33% in the pT3 group. In 6.81% of cases there was an increase in the anti-Ki 67 index and in 2.27% of the cases, there was an increase in the immunoexpression of anti-p53 when comparing Gleason score 7 (3+4) with Gleason score 7 (4+3). Conclusion: Our study confirmed differences in the Gleason score 7 (3+4) and Gleason score 7 (4+3) of PC when comparing prognostic criteria. Anti-Ki 67 and anti-PSA antibody immunostaining showed a positive correlation as the Gleason score 7 increased from (3+4) to (4+3).

https://doi.org/10.1590/s1677-5538.ibju.2024.9922

Development of nerves and vessels in the penis during the human fetal period
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Gallo, Carla B. M.

; Costa, Waldemar S. Favorito, Luciano A. Sampaio, Francisco J. B.

International braz j urol

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dec 2024, Volume 50 N. 6 Pages 764 - 771

Abstract: En | Text: En | PDF: En

ABSTRACT Introduction: Although nerves and vessels of the penis play important role in erection, there are few studies on their development in human fetus. Therefore, the objective of the present study is to analyze, quantitatively, in the corpora cavernosa and corpus spongiosum, the development of the nerves and vessels in the fetal penis at different gestational ages. Material and Methods: Fifty-six fresh, macroscopically normal human fetuses aged from 13 to 36 weeks post-conception (WPC) were used. Gestational age was determined by the foot length criterion. Penises were immediately fixed in 10% formalin, and routinely processed for paraffin embedding, after which tissue sections from the mid-shaft were obtained. We used immunohistochemical staining to analyze the nerves and vessels in the corpus cavernous and in the corpus spongiosum. These elements were identified and quantified as percentage by using the Image-J software. Results: The quantitative analysis showed that the percentage of nerves varied from 3.03% to 20.35% in the corpora cavernosa and from 1.89% to 23.88% in the corpus spongiosum. The linear regression analysis indicated that nerves growth (incidence) in the corpora cavernosa and corpus spongiosum correlated significantly and positively with fetal age (r2=0.9421, p<0.0001) and (r2=0.9312, p<0.0001), respectively, during the whole fetal period studied. Also, the quantitative analysis showed that the percentage of vessels varies from 2.96% to 12.86% in the corpora cavernosa and from 3.62% to 14.85% in the corpus spongiosum. The linear regression analysis indicated that vessels growth (appearance) in the corpora cavernosa and corpus spongiosum correlated significantly and positively with fetal age (r2=0.8722, p<0.0001) and (r2=0.8218, p<0.0001), respectively, during the whole fetal period studied. In addition, the linear regression analysis demonstrated a more intense growth rate of nerves in the corpus spongiosum during the 2nd trimester of gestation, when compared with nerves in the corpora cavernosa. In addition, the linear regression analysis demonstrated a more intense growth rate of vessels in the corpus spongiosum when compared with the corpora cavernosa, during the whole fetal period studied. Conclusions: In the fetal period, the human penis undergoes major developmental changes, notably in the content and distribution of nerves and vessels. We found strong correlation between nerves and vessels growth (amount) with fetal age, both in the corpora cavernosa and corpus spongiosum. There is significant greater proportional number of nerves than vessels during the whole fetal period studied. Also, nerves and vessels grow in a more intense rate than that of the corpora cavernosa and corpus spongiosum areas. Introduction erection fetus Therefore quantitatively ages Methods Fiftysix Fifty six fresh 1 3 postconception post conception WPC (WPC criterion 10 formalin embedding midshaft mid shaft obtained ImageJ Image J software Results 303 03 3.03 2035 20 35 20.35 189 89 1.89 2388 23 88 23.88 incidence (incidence r2=0.9421, r209421 r r2 0 9421 (r2=0.9421 p<0.0001 p00001 p 0001 r2=0.9312, r209312 9312 (r2=0.9312 p<0.0001, , respectively studied Also 296 2 96 2.96 1286 12 86 12.86 362 62 3.62 1485 14 85 14.85 appearance (appearance r2=0.8722, r208722 8722 (r2=0.8722 r2=0.8218, r208218 8218 (r2=0.8218 addition nd gestation Conclusions changes amount (amount areas 30 3.0 203 20.3 18 8 1.8 238 23.8 r2=0.9421 r20942 942 (r2=0.942 p<0.000 p0000 000 r2=0.9312 r20931 931 (r2=0.931 29 9 2.9 128 12.8 6 3.6 148 14.8 r2=0.8722 r20872 872 (r2=0.872 r2=0.8218 r20821 821 (r2=0.821 3. 20. 1. 23. r2=0.942 r2094 94 (r2=0.94 p<0.00 p000 00 r2=0.931 r2093 93 (r2=0.93 2. 12. 14. r2=0.872 r2087 87 (r2=0.87 r2=0.821 r2082 82 (r2=0.82 r2=0.94 r209 (r2=0.9 p<0.0 p00 r2=0.93 r2=0.87 r208 (r2=0.8 r2=0.82 r2=0.9 r20 (r2=0. p<0. p0 r2=0.8 r2=0. (r2=0 p<0 r2=0 (r2= p< r2= (r2 (r

https://doi.org/10.1590/s1677-5538.ibju.2024.9916

First record of Juan Fernández Petrel Pterodroma externa (Salvin, 1875) in Brazil Salvin, Salvin (Salvin 1875 187 18 1
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Barbosa, Carla Beatriz

; Sánchez-Sarmiento, Angélica María

; Ferioli, Raquel Beneton

; Leonardi, Simone Baratto

; Britto, Mariana de Karam e

; Alvarenga, Fernando Siqueira

; Nascimento, Claudia Carvalho do

; Serafini, Patrícia Pereira

; Kampel, Milton

; Gallo-Neto, Hugo

Papéis Avulsos de Zoologia

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2024, Volume 64 elocation e202464037

Abstract: En | Text: En | PDF: En

Abstract We document the first recorded occurrence of a Juan Fernández Petrel Pterodroma externa specimen in São Paulo State, South Atlantic, Brazil. This finding improves our understanding of the distribution of this pelagic species, which is rarely observed along the coast. It also suggests that unusual oceanographic conditions may disorient seabirds, causing them to appear in atypical areas. State Atlantic Brazil species coast seabirds areas

https://doi.org/10.11606/1807-0205/2024.64.037

Abdominal testicular vessel distribution in human fetuses - basis for Fowler-Stephens surgery FowlerStephens Fowler Stephens
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Benzi, Tatiana S. C. G.

; Gallo, Carla M. Fortuna, Anneliese Costa, Waldemar S. Sampaio, Francisco J.B. Favorito, Luciano A.

International braz j urol

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dec 2023, Volume 49 N. 6 Pages 749 - 756

Abstract: En | Text: En | PDF: En

ABSTRACT Purpose: To analyze the histology and distribution of abdominal testicular vessels in human fetuses Patients and Methods: We studied 19 fetuses (34 testes) ranging in age from 12 to 19 weeks post-conception. The fetuses were evaluated regarding crown-rump length (CRL), total length (TL) and body weight immediately before dissection. Each testis was dissected and embedded in paraffin, from which 5 µm thick sections were obtained and stained with Masson's trichrome and Anti-CD31 antibody to quantify the vessels. The stereological analysis was carried out with the Image Pro and Image J programs, using a grid to determine volumetric densities (Vv). Means were statistically compared using the unpaired T-test (p<0.05). Results: The fetuses presented mean weight of 222.5g, mean CRL of 15.3 cm and mean TL of 23.2 cm. All testes were in the abdominal position. The mean percentage of vessels (Vv) in the upper portion of the testis was 7.6% (4.6 to 15%) and in the lower portion the mean was 5.11% (2.3 to 9.8%), with a significant difference (p=0.0001). In the analysis between the upper portion of the right and left testes (p=0.99) and in the analysis of the lower portion of the right and left testes (p=0.83), we did not observe significant differences. Conclusion: The upper portion of the abdominal testis in human fetuses had a higher concentration of vessels than the lower portion. These results suggest that manipulation of the lower end of the testis during Fowler-Stephens surgery should be avoided in order to preserve the collateral circulation. Purpose Methods 1 34 (3 postconception. postconception post conception. conception post-conception crownrump crown rump CRL, , (CRL) (TL dissection paraffin Massons Masson s AntiCD31 AntiCD Anti CD31 CD Anti-CD3 programs Vv. Vv . Ttest T test p<0.05. p005 p p<0.05 0 05 (p<0.05) Results 2225g g 222 5g 222.5g 153 15 3 15. 232 23 2 23. position (Vv 76 7 6 7.6 4.6 46 4 (4. 15% 511 11 5.11 2.3 (2. 9.8%, 98 9.8% 9 8 9.8%) p=0.0001. p00001 p=0.0001 0001 (p=0.0001) p=0.99 p099 99 (p=0.99 p=0.83, p083 p=0.83 83 (p=0.83) differences Conclusion FowlerStephens Fowler Stephens circulation ( (CRL AntiCD3 CD3 Anti-CD p00 p<0.0 (p<0.05 22 7. 4. (4 51 5.1 2. (2 9.8 p0000 p=0.000 000 (p=0.0001 p=0.9 p09 (p=0.9 p08 p=0.8 (p=0.83 p0 p<0. (p<0.0 5. 9. p000 p=0.00 00 (p=0.000 p=0. (p=0. (p=0.8 p<0 (p<0. p=0.0 (p=0.00 p=0 (p=0 p< (p<0 (p=0.0 p= (p= (p< (p

https://doi.org/10.1590/s1677-5538.ibju.2023.9909

Anatomy of the lower hypogastric plexus applied to endometriosis: a narrative review endometriosis
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Ribeiro-Julio, Gisele Silva

; Pereira, Jorge Alves Ribeiro, Eduardo Gallo, Carla M. Favorito, Luciano A.

International braz j urol

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jun 2023, Volume 49 N. 3 Pages 299 - 306

Abstract: En | Text: En | PDF: En

ABSTRACT Objective The objective of the present study is to evaluate the anatomy of the inferior hypogastric plexus, correlating it with urological pathologies, imaging exams and surgeries of the female pelvis, especially for treatment of endometriosis. Material and Methods We carried out a review about the anatomy of the inferior hypogastric plexus in the female pelvis. We analyzed papers published in the past 20 years in the databases of Pubmed, Embase and Scielo, and we included only papers in English and excluded case reports, editorials, and opinions of specialists. We also studied two human fixed female corpses and microsurgical dissection material with a stereoscopic magnifying glass with 2.5x magnification. Results Classical anatomical studies provide few details of the morphology of the inferior hypogastric plexus (IHP) or the location and nature of the associated nerves. The fusion of pelvic splanchnic nerves, sacral splanchnic nerves, and superior hypogastric plexus together with visceral afferent fibers form the IHP. The surgeon’s precise knowledge of the anatomical relationship between the hypogastric nerve and the uterosacral ligament is essential to reduce the risk of complications and postoperative morbidity of patients surgically treated for deep infiltrative endometriosis involving the uterosacral ligament. Conclusion Accurate knowledge of the innervation of the female pelvis is of fundamental importance for prevention of possible injuries and voiding dysfunctions as well as the evacuation mechanism in the postoperative period. Imaging exams such as nuclear magnetic resonance are interesting tools for more accurate visualization of the distribution of the hypogastric plexus in the female pelvis. pathologies 2 Pubmed Scielo reports editorials specialists 25x x 5x magnification IHP (IHP nerves surgeons surgeon s period

https://doi.org/10.1590/s1677-5538.ibju.2022.9980

Evaluation of laparoscopic knot training in a silicone model
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OSORIO, LUIZ FELIPE FERNANDES

; MACIEL, CLARICE FRAGA ESTEVES

; GALLO, CARLA BRAGA MANO

; SAMPAIO, FRANCISCO J.

Revista do Colégio Brasileiro de Cirurgiões

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2023, Volume 50 elocation e20233476

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Introdução: na cirurgia videolaparoscópica os movimentos são conduzidos a partir de uma imagem magnificada de vinte vezes de um campo operatório indireto. A interface de vídeo utilizada pressupõe a necessidade de percepção de profundidade utilizando duas dimensões ao invés de três. Objetivo: avaliar a eficácia do treinamento de execução do nó laparoscópico em modelo de silicone, em cursos de 8h, e analisar a correlação dos resultados de aprendizagem com fatores como: sexo, idade, lateralidade, conhecimentos prévios em endosutura e especialidade médica. Material e Métodos: Neste estudo, prospectivo e randomizado, foram avaliados 56 alunos, que realizaram cursos de 8h de duração, com turmas de até dez alunos. Foram utilizados: uma caixa branca com câmera, tela de LCD e peça de silicone. No molde de silicone foram executados quatro exercícios: mão direita, mão esquerda, agulha a 45° e back hand. Resultados: 56 alunos (média de idade = 33,28 anos). O grupo feminino, n=18, média de idade 29,61 anos, 17 destras e 1 canhota. O grupo masculino, n=38, média de idade 34,57 anos, 35 destros, 1 canhoto e 2 ambidestros. Em ambos grupos não foram observados nenhuma correlação entre as análises de nós bem executados quando correlacionados com a idade ou sexo dos participantes. Conclusão: o treinamento de nó laparoscópico, em moldes de silicone, em cursos de 8h de duração, mostrou-se eficaz. Fatores como sexo, idade, lateralidade, conhecimentos prévios em endosutura e especialidade médica, não interferem nos resultados do aprendizado. Introdução indireto três Objetivo h lateralidade médica Métodos estudo randomizado 5 duração utilizados câmera exercícios direita esquerda 45 hand Resultados 3328 33 28 33,2 anos. anos . anos) feminino n18 n 18 n=18 2961 29 61 29,6 canhota masculino n38 38 n=38 3457 34 57 34,5 3 destros ambidestros participantes Conclusão mostrouse mostrou se eficaz aprendizado 4 332 33, n1 n=1 296 6 29, n3 n=3 345 34, n=

ABSTRACT Introduction: in videolaparoscopic surgery, movements are conducted from a twenty times magnified image of an indirect operative field. The video interface used assumes the need for depth perception using two dimensions instead of three. Objective: to evaluate the effectiveness of training to perform the laparoscopic knot in a silicone model, in 8-hour courses, and to analyze the correlation of learning outcomes with factors such as: sex, age, laterality, previous knowledge in endosuture and medical specialty. Material and Methods: in this prospective and randomized study, 56 students were evaluated, who took 8-hour courses, with groups of up to ten students. We used: a white box with camera, LCD screen and silicone piece. Four exercises were performed on the silicone mold: right hand, left hand, needle at 45° and back hand. Results: 56 students (mean age = 33.28 years). The female group, n=18, mean age 29.61 years, 17 right-handed and 1 left-handed. The male group, n=38, mean age 34.57 years, 35 right-handers, 1 left-handed and 2 ambidextrous. In both groups, no correlation was observed between the analyzes of well performed knots when correlated with the age or sex of the participants. Conclusion: laparoscopic knot training, in silicone molds, in 8 h courses, proved to be effective. Factors such as gender, age, laterality, previous knowledge in endosuture and medical specialty do not interfere with the learning results. Introduction surgery field three Objective model 8hour hour courses laterality Methods study 5 evaluated camera piece mold hand 45 Results 3328 33 28 33.2 years. years . years) group n18 n 18 n=18 2961 29 61 29.6 righthanded handed lefthanded. lefthanded handed. n38 38 n=38 3457 34 57 34.5 3 righthanders, righthanders handers, handers right-handers ambidextrous participants Conclusion molds effective gender results 4 332 33. n1 n=1 296 6 29. n3 n=3 345 34. n=

https://doi.org/10.1590/0100-6991e-20233476-en

Kidney surface development in human fetuses: study applied to radiological diagnosis
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Favorito, Luciano A.

; Lobo, Marcio Luiz P. Fernandes, Ana Vitória Gallo, Carla M. Sampaio, Francisco J. B.

International braz j urol

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dec 2022, Volume 48 N. 6 Pages 930 - 936

Abstract: En | Text: En | PDF: En

ABSTRACT Objective: To evaluate the anatomical aspects of the kidney surface in human fetuses during the second gestational trimester. Material and Methods: We studied 108 kidneys obtained from 54 human fetuses (29 males and 25 females). The kidney was dissected and the number of clefts was counted. The renal volume was also assessed. To compare the quantitative data in both sexes, the Students-t-test was used (p < 0.05). Simple linear correlations were calculated for all kidney measurements, according to fetal age. Statistical analysis was performed with the R program (Version 3.5.1). Results: The fetuses ranged in age between 11.4 to 23 weeks post-conception. The renal volume of the right kidney ranged from 0.09 to 2.397 cm (mean=0.8479) and the renal volume of the left kidney ranged from 0.07 to 2.416 cm (mean=0.8036). The mean number of renal clefts in fetuses studied was 15.25 (7 to 28). There was no statistical significant difference in renal clefts between the sides either in males (p = 0.646) or in females (p = 0.698). Also, there was no significant difference in the mean number of renal clefts between male and female fetuses in right kidney (p = 0.948) and in left kidney (p = 0.939). Conclusions: The number of renal clefts has a great variation, weak correlation and no tendency to decrease during the 2nd gestational trimester. The number of clefts in right kidney of total sample and female fetuses has a significant development with age.

https://doi.org/10.1590/s1677-5538.ibju.2022.9977

Epididymal disjunction anomalies in undescended testis – a factor associated with spermatic obstruction
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Logsdon, Natasha T.

; Gallo, Carla M. Sampaio, Francisco J. B. Favorito, Luciano A.

International braz j urol

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apr 2022, Volume 48 N. 2 Pages 336 - 346

Abstract: En | Text: En | PDF: En

ABSTRACT Background: To analyze the incidence of epididymal anomalies (EAs) associated to spermatic obstruction in patients with undescended testis (UT) according to testicular position and age. Materials and Methods: We studied 87 patients (110 testis) with cryptorchidism and analyzed the presence of EAs correlated with the testicular position, age and patency of the processus vaginalis (PV). To analyze the relations between the testis and epididymis we considered three situations: (a) Normal pattern: the epididymis was attached to the testis at the head and tail and epididymis totally attached to the testis; (b) EAs: when the epididymis was attached to the testis only at the head (Figure-1A) and (c) EAs associated to spermatic obstruction: epididymis was attached to the testis only at the tail (Figure-1B) and when there are no visible connection between testis and epididymis (Figure-1C). We used the Wilcoxon-Mann-Whitney test and the Chi-square test for contingency analysis (p <0.05). Results: The mean age of the patients was 5.18 years (SD=2.867). Of 110 testes analyzed, 14 were abdominal (12.72%); 83 inguinal (75.45%) and 13 suprascrotal (11.81%). Normal relationships between testis and epididymis were observed in 54 patients (62.1%) with no significant differences in relation to the patient's age (p=0.666). Epididymal tail disjunction was observed in 23 patients (26.44%), with no significant differences in relation to age (p=0.59). EAs associated to spermatic obstruction were observed in 16 patients (18.4%), also with no significant differences in relation to age (p=0.684). We did not observe significant correlation between the testis position and the incidence of EAs (p=0.119). We did not observe significant correlations between patency of the PV (64.7%) and incidence of EAs (p=0.742). Conclusions: Epididymal anomalies associated with spermatic obstruction are present in almost 20% of undescended testes, without significant correlation with age, testicular position and patency of the PV. This information needs to be correlated to the infertility risk of this congenital anomaly.

https://doi.org/10.1590/s1677-5538.ibju.2022.99.07

Vulnerabilities of nurses in an intensive care unit: an integrative review
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Vocci, Marcelli Cristine

; Gallo, Isabella Gandolfi

; Spiri, Wilza Carla

; Borgato, Maria Helena

; Fontes, Cassiana Mendes Bertoncello

Revista Brasileira de Enfermagem

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2021, Volume 74 N. 3 elocation e20200724

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

RESUMO Objetivos: identificar as vulnerabilidades dos enfermeiros atuantes em unidade de terapia intensiva. Métodos: foi realizada revisão integrativa no período de 2006 a 2019, com busca nas plataformas/bases de dados LILACS, BDENF, SciELO, MEDLINE, Scopus, CINAHL e Web of Science. Foi utilizado o referencial teórico da ergologia, de Schwartz, e a pergunta norteadora “Quais são as principais vulnerabilidades dos enfermeiros atuantes em unidade de terapia intensiva?”. Resultados: onze artigos inclusos. Emergiram cinco temas de vulnerabilidades: física; emocional; processo de comunicação; processo de cuidar; e organizacional. Constatou-se que a vulnerabilidade organizacional se manteve como um fator comum e de intersecção no desenvolvimento das outras quatro. Conclusões: as vulnerabilidades encontradas relacionaram-se aos elementos: físico, emocional; de comunicação; do processo de cuidar; e organizacional da instituição. O aspecto organizacional fez intersecção com os outros, configurando-se como nuclear nesse contexto.

ABSTRACT Objectives: to identify vulnerabilities of nurses who work in an intensive care unit. Methods: an integrative review was held from 2006 to 2019, with searches on the platforms/databases LILACS, BDENF, SciELO, MEDLINE, Scopus, CINAHL, and Web of Science. The theoretical framework of ergology, by Schwartz, was used and the guiding question “What are the main vulnerabilities of nurses who work in an intensive care unit”? Results: eleven articles were included. Five topics of vulnerabilities emerged: physical, emotional, communication process, care process, and organizational. We observed that the organizational vulnerability was kept as a common and intersection factor in developing the other four. Conclusions: vulnerabilities found have a relationship to the physical, emotional, communication, care process, and institution organization elements. The organization aspect intersected with the others, configuring itself as the core in this context.

RESUMEN Objetivos: identificar las vulnerabilidades de los enfermeros actuantes en unidad de cuidados intensivos. Métodos: ha sido realizada revisión integrativa entre 2006 a 2019, con búsqueda en las plataformas/bases de datos LILACS, BDENF, SciELO, MEDLINE, Scopus, CINAHL y Web of Science. Ha sido utilizado el referencial teórico de la ergología, de Schwartz, y la pregunta de investigación “¿Cuáles son las principales vulnerabilidades de los enfermeros actuantes en unidad de cuidados intensivos?”. Resultados: once artículos inclusos. Emergieron cinco temas de vulnerabilidades: física; emocional; proceso de comunicación; proceso de cuidar; y organizacional. Constató que la vulnerabilidad organizacional se mantuvo como un factor común y de intersección en el desarrollo de las otras cuatro. Conclusiones: las vulnerabilidades encontradas se relacionaron a los elementos: físico, emocional; de comunicación; del proceso de cuidar; y organizacional de la institución. El aspecto organizacional hizo intersección con los otros, configurándose como nuclear en eso contexto.

https://doi.org/10.1590/0034-7167-2020-0724 173 downloads

10.

Consenso argentino en gestión efectiva de clínicas de anticoagulación para uso de antagonistas de la vitamina K
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Ceresetto, José M Duboscq, Cristina Korin, Jorge Fondevila, Carlos Casais, Patricia Rossi, Andrea Scazziota, Alejandra Martinuzzo, Marta Aris Cancela, María Esther Rosa, Claudio Pombo, Gonzalo Guimelli, Carla Adamczuk, Yolanda Martí, Alejandra Penchasky, Diana Riveros, Dardo Puente, Dolores Celebrin, Lucía Molnar, Soledad Meschengieser, Susana Castro Ríos, Miguel Blanco, Alicia Hendler, Héctor Brodsky, Andrés Sánchez Luceros, Analía Negri Aranguren, Pedro Fedele, José Luis Merlo, Claudio Raña, Pablo Gumpel, Carina Colorio, Cecilia Grand, Beatriz Canónico, Virginia Rossi, Eleonora Colimodio, Paulo Orlando, Sergio Fassi, Daniel Arias, Mirta Viudez, Laura Farreras, Roberto Martínez, Pablo Ferro, Hugo Casali, Claudia Baques, Alejandra Arbesú, Guillermo Viñuales, Susana Medina, Fernanda Cortés, Verónica Gallo, María Del Carmen Ehelou, Ludmila Barrera, Luis Rey, Irene De Larrañaga, Gabriela Figueroa, Flavia Vilaseca, Alicia Kuri, Isabel Maneyro, Alberto Otaran, María Xavier, David Luis Garbiero, Susana Salviú, Julieta Fontenla, Patricia Eckhardt, Andrea Bomparola, Carolina Fornasiero, Laura

Medicina (Buenos Aires)

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sep 2020, Volume 80 Suppl. 4 Pages 1 - 26

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

Resumen El tratamiento de un paciente anticoagulado con antagonistas de la vitamina K (AVK) sigue siendo un desafío, especialmente en regiones donde, por el costo, los dicumarínicos son todavía la alternativa más buscada a la hora de elegir un anticoagulante oral. Las clínicas de anticoagulación han demostrado ser la forma más eficiente y segura de evitar complicaciones trombóticas y hemorrágicas y de mantener al paciente en rango óptimo de tratamiento. Sin embargo, requieren de una adecuada infraestructura y personal capacitado para que funcionen eficientemente. En este consenso argentino se propone una serie de parámetros para la gestión efectiva de una clínica de anticoagulación. El objetivo es lograr una elevada calidad desde el punto de vista clínico-asistencial a través de un laboratorio de hemostasia de excelencia. Los criterios desarrollados en el documento fueron consensuados por un amplio grupo de expertos especialistas en hematología y en bioquímica de todo el país. Estos criterios deben adaptarse a la irregular disponibilidad de recursos de cada centro, pero siempre se los debe tener en cuenta a la hora de indicar el tratamiento anticoagulante con estas drogas. Tener en consideración estas premisas nos permitirá optimizar la atención del enfermo anticoagulado con AVK y de esta forma minimizar las intercurrencias trombóticas y hemorrágicas a las que está expuesto, para así honrar nuestra promesa de no dañar al paciente.

Abstract Treating an anticoagulated patient with vitamin K antagonists (VKA) remains a challenge, especially in areas where dicoumarins are still the first drug of choice due to the cost of other oral anticoagulants. Anticoagulation clinics have proven to be the most efficient and safe way to avoid thrombotic and hemorrhagic complications and to keep patients in optimal treatment range. However, they require adequate infrastructure and trained personnel to work properly. In this Argentine consensus we propose a series of guidelines for the effective management of the anticoagulation clinics. The goal is to achieve the excellence in both the clinical healthcare and the hemostasis laboratory for the anticoagulated patient. The criteria developed in the document were agreed upon by a large group of expert specialists in hematology and biochemistry from all over the country. The criteria presented here must always be considered when indicating VKA although they had to be adapted to the unequal reality of each center. Taking these premises into consideration will allow us to optimize the management of the anticoagulated patient with VKA and thus minimize thrombotic and hemorrhagic intercurrences, in order to honor our promise not to harm the patient.

11.

Diagnóstico y tratamiento de la etapa aguda del accidente cerebrovascular isquémico: Guía de práctica clínica del Seguro Social del Perú (EsSalud)
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Sequeiros-Chirinos, Joel Mario

; Alva-Díaz, Carlos A.

; Pacheco-Barrios, Kevin

; Huaringa-Marcelo, Jorge

; Huamaní, Charles

; Camarena-Flores, Carla E.

; Durand-Castro, Walter S.

; Valencia-Chávez, Ana María

; Ecos-Quispe, Rosa L.

; Estupinan-Valdez, Paula I.

; Gallo-Guerrero, Marla

; Huamaní-Mendoza, Marlene Doris Mariños-Sánchez, Evelyn Vanessa Morón-Cabrera, María Elizabeth Pulachet-Contreras, Elena Ramos-Auccasi, Alfredo Rodríguez-Kadota, Liliana Saavedra-Rocha, César Chávez-Rimache, Lesly Timaná-Ruiz, Raúl

Acta Médica Peruana

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jan 2020, Volume 37 N. 1 Pages 54 - 73

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

RESUMEN Objetivo: proveer recomendaciones clínicas basadas en evidencia para el diagnóstico y tratamiento de la etapa aguda del ataque cerebrovascular isquémico en EsSalud. Materiales y métodos: se conformó un grupo elaborador de la guía (GEG) que incluyó médicos especialistas y metodólogos. El GEG formuló 8 preguntas clínicas a ser respondidas por la presente GPC. Se realizó búsquedas sistemáticas de revisiones sistemáticas y -cuando fue considerado pertinente- estudios primarios en Medline y Cochrane Controlled Register of Trials durante el 2018. Se seleccionó la evidencia para responder cada una de las preguntas clínicas planteadas. La certeza de la evidencia fue evaluada usando la metodología Grading of Recommendations Assessment, Development, and Evaluation (GRADE). En reuniones de trabajo periódicas, el GEG usó la metodología GRADE para revisar la evidencia y formular las recomendaciones, los puntos de buenas prácticas clínicas y el flujograma de diagnóstico y tratamiento. Finalmente, la GPC fue aprobada con Resolución N° 128-IETSI-ESSALUD-2019. Resultados: la presente GPC abordó 8 preguntas clínicas, divididas en cuatro temas: tamizaje, diagnóstico, tratamiento, soporte y rehabilitación. En base a estas preguntas se formularon 28 recomendaciones (8 fuertes y 20 condicionales), 38 puntos de buena práctica clínica, 1 nota de implementación y 2 flujogramas. Conclusión: el presente artículo resume la metodología y las conclusiones basadas en evidencias de la GPC para el diagnóstico y tratamiento de la etapa aguda del ataque cerebrovascular isquémico en EsSalud.

ABSTRACT Objective: to provide evidence based clinical recommendations for the diagnosis and therapy of the acute stage of ischemic cerebrovascular accident in EsSalud. Materials and methods : a group for producing the guideline was conveyed, including specialized physicians and methodologists. The group prepared 8 clinical questions to be answered by the guideline. Systematic searches of previous reviews were performed, and - when it was deemed necessary - primary studies in Medline and the Cochrane Controlled Registry of Trials for 2018 were reviewed. Evidence was selected aiming to respond each one of the proposed clinical questions. Certainty of the evidence was determined using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. In periodic work sessions, the group used GRADE methodology for reviewing the evidence and generated recommendations, good clinical practice items, and designed flow charts for both diagnosis and therapy. Finally, the guide was approved with the decree N° 128-IETSI-ESSALUD-2019. Results : this clinical practice guideline focused in 8 clinical questions, which were divided into four topics: screening, diagnosis, therapy, support and rehabilitation. On the basis of these questions, 28 recommendations were formulated (8 strong and 20 conditional), 38 items for good clinical practice, 1 implementation note, and 2 flow charts. Conclusion : this paper summarizes both evidence based methodology and conclusions from a new clinical practice guide for diagnosis and therapy of the acute stage of a cerebrovascular accident in EsSalud.

https://doi.org/10.35663/amp.2020.371.869

12.

Expression of stromal elements of prostatic adenocarcinoma in different gleason scores
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Osorio, Clarice Fraga Esteves Maciel

; Costa, Waldemar Silva

; Gallo, Carla Braga Mano

; Sampaio, Francisco José Barcellos

Acta Cirúrgica Brasileira

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oct 2019, Volume 34 N. 10 elocation e201901005

Abstract: En | Text: En | PDF: En

Abstract Purpose: To quantify and compare the expression of stromal elements in prostate adenocarcinoma of different Gleason scores with non-tumor area (control). Methods: We obtained 132 specimens from samples of prostate peripheral and transition zone. We analyzed the following elements of the extracellular matrix: collagen fibers, elastic system, smooth muscle fibers and blood vessels. The tumor area and non-tumor area (control) of the TMA (tissue microarray) were photographed and analyzed using the ImageJ software. Results: The comparison between the tumor area and the non-tumor area showed significant differences between stromal prostate elements. There was an increase of collagen fibers in the tumor area, mainly in Gleason 7. Elastic system fibers showed similar result, also from the Gleason 7. Blood vessels showed a significant increase occurred in all analyzed groups. The muscle fibers exhibited a different behavior, with a decrease in relation to the tumor area. Conclusions: There is a significant difference between the extracellular matrix in prostate cancer compared to the non-tumor area (control) especially in Gleason 7. Important modifications of the prostatic stromal elements strongly correlate with different Gleason scores and can contribute to predict the pathological staging of prostate cancer.

https://doi.org/10.1590/s0102-865020190100000005 784 downloads

13.

Effect of a high-fat diet on the rat bladder wall and bioactive action of Brazil nut oil
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Souza, Aline Costa de

; Gallo, Carla Braga Mano Passos, Magna Cottini da Fonseca Croccia, Carolina Miranda, Glauciane Lacerda Sampaio, Francisco José Barcellos Gregório, Bianca Martins

International braz j urol

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jan 2019, Volume 45 N. 1 Pages 161 - 168

Abstract: En | Text: En | PDF: En

ABSTRACT High-fat diet-induced obesity is associated with metabolic disorders. The Brazil nut has bioactive substances and has been used to control the damage caused by obesity in several organs. The work intended to show the damage caused by high-fat diet in the bladder wall and if the Brazil nut oil added to the diet could ameliorate or reverse this effect. Sixty-day-old rats were divided into two groups: C (control, n = 30) and HF (high-fat, n = 30) diets. At 90 days, 10 animals of each group were sacrificed. The others were divided into 4 groups: C and HF (animals that maintained their previous diet, n = 10 for each group) and C / Bno and HF / Bno (animals whose control or high-fat diet was supplemented by Brazil nut oil, n = 10 for each group). Sacrifice occurred at 120 days, and the bladders were removed and analyzed. Epithelial height was increased in the HF compared to the C group. In contrast, the C / Bno had a lower epithelial height compared to the others. The percentage of collagen between the detrusor muscle fibers was significantly greater in C / Bno, HF and HF / Bno than in control group. The HF had a larger muscle fiber diameter than the C group, while the C / Bno presented lower values than the HF and HF / Bno groups. HF diets induced bladder wall damage. These changes in the rat's bladder wall were partially reversed by the Bno.

https://doi.org/10.1590/s1677-5538.ibju.2018.0547 641 downloads

14.

Relación entre estrés laboral y burnout en una muestra de controladores de tráfico aéreo en Chile
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Aguirre Mas, Carla Gallo, Agustina Ibarra, Alexander Sánchez García, José Carlos

Ciencias Psicológicas

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nov 2018, Volume 12 N. 2 Pages 239 - 248

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

Resumen: Esta investigación tiene por objetivo hallar la relación entre el burnout, el estrés laboral, la satisfacción laboral y el conflicto trabajo-familia en controladores de tráfico aéreo, como variables diferenciales: edad, sexo, estado civil, permanencia laboral, tipo de contrato y presencia o ausencia de hijos. Esta investigación es de tipo descriptivo-correlacional de corte transversal. Se aplicaron los Cuestionario: MBI-GS de Burnout, Instrumento de Medición de detonantes de Estrés Laboral para pilotos (IMDELP) y el Cuestionario Conflicto Trabajo-Familia. La muestra fue de 161 personas, mediante muestreo intencionado. Los resultados indican que se obtuvo un nivel moderado de burnout, estrés laboral y conflicto trabajo-familia, existiendo diferencias significativas y directamente proporcionales a la hora de analizar las dimensiones del burnout relacionándolas con extensión de las jornadas de trabajo y agotamiento, agotamiento y conflicto trabajo-familia, estrés laboral y cinismo

Abstract: The purpose of the present study was to identify the relation between burnout syndrome, work stress, work satisfaction and work-family conflict in a sample of air traffic controllers, taking in consideration the following variables: age, sex, civil status, work permanence, contract type and presence or absence of children. In this descriptive-correlational study we used the: MBI-GS of Burnout Questionnaire, detonating questionnaire Instrument of measurement of Work Stress for pilots (IMDELP), and the Work- Family Conflict Questionnaire. The sample was 161 Air Traffic Controllers, through intentional sampling. The results indicate a moderate level of burnout, work-related stress and work-family conflict. There were significant and directly proportional differences when analyzing the dimensions of burnout, relating them to the length of work and exhaustion, exhaustion and conflict work-family, work stress and cynicism

https://doi.org/10.22235/cp.v12i2.1688 7774 downloads

15.

Biochemical and molecular characterization of 3-Methylcrotonylglycinuria in an Italian asymptomatic girl
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Cozzolino, Carla

; Villani, Guglielmo RD Frisso, Giulia Scolamiero, Emanuela Albano, Lucia Gallo, Giovanna Romanelli, Roberta Ruoppolo, Margherita

Genetics and Molecular Biology

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jun 2018, Volume 41 N. 2 Pages 379 - 385

Abstract: En | Text: En | PDF: En

Abstract 3-Methylcrotonylglycinuria is an organic aciduria resulting from deficiency of 3-methylcrotonyl-CoA carboxylase (3-MCC), a biotin-dependent mitochondrial enzym carboxylating 3-methylcrotonyl-CoA to 3-methylglutaconyl-CoA during leucine catabolism. Its deficiency, due to mutations on MCCC1 and MCCC2 genes, leads to accumulation of 3-methylcrotonyl-CoA metabolites in blood and/or urine, primarily 3-hydroxyisovaleryl-carnitine (C5-OH) in plasma and 3-methylcrotonyl-glycine (3-MCG) and 3-hydroxyisovaleric acid (3-HIVA) in the urine. The phenotype of 3-MCC deficiency is highly variable, ranging from severe neurological abnormalities and death in infancy to asymptomatic adults. Here we report the biochemical and molecular characterization of an Italian asymptomatic girl, positive for the newborn screening test. Molecular analysis showed two mutations in the MCCC2 gene, an already described missense mutation, c.691A > T (p.I231F), and a novel splicing mutation, c.1150-1G > A. We characterized the expression profile of the splice mutation by functional studies.

https://doi.org/10.1590/1678-4685-gmb-2017-0093 1145 downloads

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