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Reconstrução do braço com retalho miocutâneo do músculo grande dorsal após ressecção de sarcomas: relato de dois casos e descrição da técnica cirúrgica sarcomas
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ORLETTI, LEONARDO

; CARDONA, ANA LUIZA MIRANDA

; MAZZOCCO, ANA PAULA

; BARRETO, MARCIO DINIZ

; FAGUNDES FILHO, LUIZ AUGUSTO DE CASTRO

Revista Brasileira de Cirurgia Plástica

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Dez 2022, Volume 37 Nº 4 Páginas 505 - 509

Resumo: En Pt | Texto: En Pt | PDF: En | PDF: Pt

ABSTRACT Soft tissue sarcomas are rare malignant neoplasms arising from the mesenchyme, most commonly found in the limbs. Surgical resection with free margins greater than 1 cm is essential to obtain a cure for the patient. Radiation therapy can be combined with treatment in selected cases. Reconstruction of the upper limbs after extended resections is a challenge. The latissimus dorsi myocutaneous flap (LDMF) is an option in injuries to the upper limbs, especially the proximal and middle thirds of the arm, with preservation of limb function and primary closure of the resection area. We report two cases of arm resection and reconstruction using LDMF, focusing on the surgical technique description. mesenchyme patient challenge LDMF (LDMF area description

RESUMO Os sarcomas de partes moles são neoplasias malignas raras originadas do mesênquima, mais comumente encontradas em membros. A ressecção cirúrgica com margens livres acima de 1cm é fundamental para obter a cura do paciente. A radioterapia pode ser combinada ao tratamento em casos selecionados. A reconstrução dos membros superiores após ressecções alargadas é um desafio. O retalho miocutâneo do músculo grande dorsal (RMGD) é uma opção em casos de lesões em membros superiores, sobretudo terço proximal e médio do braço, com preservação da função do membro e fechamento primário da área de ressecção. Relatamos dois casos de ressecção e reconstrução do braço utilizando RMGD com foco na descrição da técnica cirúrgica. mesênquima cm paciente selecionados desafio (RMGD

https://doi.org/10.5935/2177-1235.2022rbcp.623-pt

PERFIL EPIDEMIOLÓGICO E DISTRIBUIÇÃO ESPACIAL DA HANSENÍASE EM PAULO AFONSO, BAHIA
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Azevedo, Yasmin Pereira

; Bispo, Vitor Augusto da Silva

; Oliveira, Ronaldo Inácio de

; Gondim, Bruno Bezerra

; Santos, Sélton Diniz dos

; Natividade, Márcio Santos da

; Nery, Joilda Silva

Revista Baiana de Enfermagem

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2021, Volume 35 elocation e37805

Resumo: En Es Pt | Texto: En Es Pt | PDF: En | PDF: Es | PDF: Pt

Objectives to analyze the epidemiological characteristics and distribution of new leprosy cases in the population of Paulo Afonso, Bahia, Brazil, between 2000 and 2015. Method descriptive study with all new cases of leprosy reported at the Notifiable Diseases Information System. Sociodemographic and clinical variables were used and annual detection coefficients were calculated. Population estimates were obtained from the Brazilian Institute of Geography and Statistics. Results most of the 1,069 new reported cases were female (57.2%), living in the urban area (92%), brown race/color (66.92%), elementary school (67.6%), over fifteen years of age (92.5%), tuberculoid clinical form (48.26%), paucibacillary (62.3%), degree of physical disability at diagnosis (45.93%) and cure (29.75%). Conclusion the epidemiological profile of leprosy in Paulo Afonso is similar to the national one, with variations in leprosy detection coefficients between years and spatial analysis showing heterogeneous distribution, with a higher concentration of cases in peripheral neighborhoods.

Objetivos analizar las características epidemiológicas y la distribución de nuevos casos de lepra en la población de Paulo Afonso, Bahía, entre 2000 y 2015. Método estudio descriptivo con todos los nuevos casos de lepra reportados en el Sistema de Información de Enfermedades Notificables. Se utilizaron variables sociodemográficas y clínicas y se calcularon los coeficientes anuales de detección. Las estimaciones de población se obtuvieron del Instituto Brasileño de Geografía y Estadística. Resultados la mayoría de los 1.069 nuevos casos notificados fueron mujeres (57,2%), que viven en el área urbana (92%), raza/color parda (66,92%), escuela primaria (67,6%), con más de quince años (92,5%), forma clínica de tuberculoide (48,26%), paucibacilario (62,3%), grado de discapacidad física al diagnóstico (45,93%) y en la cura (29,75%). Conclusión el perfil epidemiológico de la lepra en Paulo Afonso es similar al nacional, hubo variaciones en los coeficientes de detección de lepra entre años y el análisis espacial mostró una distribución heterogénea, con una mayor concentración de casos en barrios periféricos.

Objetivos analisar as características epidemiológicas e distribuição dos casos novos de hanseníase na população de Paulo Afonso, Bahia, entre 2000 e 2015. Método estudo descritivo com todos os casos novos de hanseníase notificados no Sistema de Informações de Agravos de Notificação. Foram utilizadas variáveis sociodemográficas e clínicas e calculados os coeficientes de detecção anuais. Estimativas populacionais foram obtidas no Instituto Brasileiro de Geografia e Estatística. Resultados a maioria dos 1.069 casos novos notificados foi do sexo feminino (57,2%), residiam na zona urbana (92%), raça/cor parda (66,92%), ensino fundamental (67,6%), maiores de quinze anos (92,5%), forma clínica tuberculoide (48,26%), paucibacilares (62,3%), grau de incapacidade física no diagnóstico (45,93%) e na cura (29,75%). Conclusão o perfil epidemiológico da hanseníase em Paulo Afonso é similar ao nacional, houve variações nos coeficientes de detecção da hanseníase entre os anos e a análise espacial evidenciou distribuição heterogênea, com maior concentração de casos nos bairros periféricos.

https://doi.org/10.18471/rbe.v35.37805 217 downloads

Antineutrophil cytoplasmic antibody profiles differ according to type of primary sclerosing cholangitis and autoimmune hepatitis
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Crescente, Juliana Goldbaum

; Dellavance, Alessandra

; Diniz, Marcio Augusto

; Carrilho, Flair Jose

; Andrade, Luis Eduardo Coelho de

; Cançado, Eduardo Luiz Rachid

Clinics

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2021, Volume 76 elocation e2228

Resumo: En | Texto: En | PDF: En

OBJECTIVES: To determine the frequency of the antineutrophil cytoplasmic antibodies (ANCA), antiproteinase-3 and antimyeloperoxidase, in primary sclerosing cholangitis (PSC) with or without inflammatory bowel disease (IBD+ or IBD-) and in different types of autoimmune hepatitis (AIH). Additionally, to verify the agreement between ANCA patterns by indirect immunofluorescence and their antigenic specificities by ELISA. METHODS: For this study, 249 patients were enrolled (42 PSC/IBD+; 33 PSC/IBD-; 31 AIH type-1; 30 AIH type-2; 31 AIH type-3; 52 primary biliary cirrhosis; 30 healthy controls) whose serum samples were tested for ANCA autoantibodies. RESULTS: There were fewer female subjects in the PSC/IBD- group (p=0.034). Atypical perinuclear-ANCA was detected more frequently in PSC/IBD+ patients than in PSC/IBD- patients (p=0.005), and was significantly more frequent in type-1 (p<0.001) and type-3 AIH (p=0.012) than in type-2 AIH. Proteinase-3-ANCA was detected in 25 samples (only one with cytoplasmic-ANCA pattern), and more frequently in PSC/IBD+ than in PSC/IBD- patients (p=0.025). Myeloperoxidase-ANCA was identified in eight samples (none with the perinuclear-ANCA pattern). Among the 62 reactive samples for atypical perinuclear-ANCA, 13 had antigenic specific reactions for proteinase-3 and myeloperoxidase. CONCLUSIONS: PSC/IBD+ differed from PSC/IBD- in terms of sex and proteinase 3-ANCA and atypical perinuclear-ANCA reactivity, the latter of which was more frequently detected in type-1 and type-3 AIH than in type-2 AIH. There was no agreement between ANCA patterns and antigenic specificities in IBD and autoimmune liver diseases, which reinforces the need for proteinase-3 and myeloperoxidase antibody testing.

https://doi.org/10.6061/clinics/2021/e2228 431 downloads

Palliative care consultation team: symptom relief in first 48 hours of hospitalization
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Silva, Magda Aparecida dos Santos

; Diniz, Marcio Augusto

; Carvalho, Ricardo Tavares de

; Chiba, Toshio

; Mattos-Pimenta, Cibele Andrucioli de

Revista Brasileira de Enfermagem

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2020, Volume 73 Nº 6 elocation e20190391

Resumo: Pt En Es | Texto: Pt En Es | PDF: Pt | PDF: En | PDF: Es

RESUMO Objetivo: Comparar o alívio de sintomas obtido por equipe interconsultora em cuidados paliativos (ICP) ao obtido por equipe de cuidado tradicional (CT), em doentes com câncer avançado nas primeiras 48 horas de hospitalização. Método: Alocados nos Grupos ICP e Grupo CT, 290 pacientes foram avaliados pela Escala de Sintomas de Edmonton (ESAS) nas primeiras 48 horas da hospitalização. O desfecho principal foi a redução mínima de 2 pontos na intensidade de sintomas. Resultados: Em 48 horas, o Grupo ICP teve redução de 2 pontos nas médias das diferenças (p < 0,001) da dor, náusea, dispneia e depressão; e o Grupo CT, na náusea e prejuízo do sono (p < 0,001). Regressão Logística Múltipla mostrou para o Grupo ICP maior chance de alívio da dor (RC 2,34; CI 1,01-5,43; p = 0,049). Conclusão: Houve superioridade do Grupo ICP para alívio da dor, dispneia e depressão. Estudos que ampliem a compreensão sobre modalidades de equipe são necessários.

ABSTRACT Objective: To compare the relief of symptoms provided by palliative care consultation team (PCCT) compared to the traditional care team (TC), in patients with advanced cancer in the first 48 hours of hospitalization. Method: Allocated to PCCT Group and TC Group, this study assessed 290 patients according to the Edmonton Symptom Assessment System (ESAS) within the first 48 hours of hospitalization. The main outcome was a minimum 2-point reduction in symptom intensity. Results: At 48 hours, the PCCT Group had a 2-point reduction in the mean differences (p <0.001) in pain, nausea, dyspnea, and depression; and TC Group, on nausea and sleep impairment (p <0.001). Multiple Logistic Regression found for the PCCT Group a greater chance of pain relief (OR 2.34; CI 1.01-5.43; p = 0.049). Conclusion: There was superiority of the PCCT Group for pain relief, dyspnea and depression. There is a need for more studies that broaden the understanding of team modalities.

RESUMEN Objetivo: Comparar el alivio de síntomas obtenido por equipo interconsultor en cuidados paliativos (ICP) al obtenido por equipo de cuidado tradicional (CT), en enfermos con cáncer avanzado en las primeras 48 horas de hospitalización. Método: Alocados en los Equipos ICP y Equipo CT, 290 pacientes han sido evaluados por la Escala de Síntomas de Edmonton (ESAS) en las primeras 48 horas de la hospitalización. El desenlace principal ha sido la reducción mínima de 2 puntos en la intensidad de síntomas. Resultados: En 48 horas, el Equipo ICP tuvo reducción de 2 puntos en las medias de las diferencias (p < 0,001) del dolor, náusea, disnea y depresión; y el Equipo CT, en la náusea y perjuicio del sueño (p < 0,001). Regresión Logística Múltiple mostró para el Equipo ICP mayor oportunidad de alivio del dolor (RC 2,34; CI 1,01-5,43; p = 0,049). Conclusión: Hubo superioridad del Equipo ICP para alivio del dolor, disnea y depresión. Estudios que amplíen la comprensión acerca de las modalidades de equipo son necesarios.

https://doi.org/10.1590/0034-7167-2019-0391 871 downloads

Palliative care consultation team: symptom relief in first 48 hours of hospitalization
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Silva, Magda Aparecida dos Santos

; Diniz, Marcio Augusto

; Carvalho, Ricardo Tavares de

; Chiba, Toshio

; Mattos-Pimenta, Cibele Andrucioli de

Revista Brasileira de Enfermagem

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2020, Volume 73 Nº 6 elocation e20190391

Resumo: En Es Pt | Texto: En Es Pt | PDF: En | PDF: Es | PDF: Pt

https://doi.org/10.1590/0034-7167-2019-0391 27 downloads

Higher MELD score increases the overall cost on the waiting list for liver transplantation: a micro-costing analysis based study
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TURRI, Jose Antonio Orellana

; DECIMONI, Tassia Cristina

; FERREIRA, Leandro Augusto

; DINIZ, Marcio Augusto

; HADDAD, Luciana Bertocco de Paiva

; CAMPOLINA, Alessandro Gonçalves

Arquivos de Gastroenterologia

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Jul 2017, Volume 54 Nº 3 Páginas 238 - 245

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

RESUMO CONTEXTO: O período pré-transplante é complexo e inclui grande quantidade de procedimentos. A gravidade da doença hepática predispõe a um alto número de internações e procedimentos de alto custo. Estudos em avaliação econômica são uma importante ferramenta para o manejo dos custos em lista de espera para o transplante hepático. OBJETIVO: O objetivo do presente estudo foi avaliar o custo total do paciente em lista de espera para o transplante hepático e os principais recursos relacionados ao alto custo. MÉTODOS: Foi realizado um estudo de coorte em 482 pacientes registrados em lista de espera para o transplante hepático. Os pacientes foram acompanhados por um período de 24 meses, no qual foram avaliados todos os custos de materiais, medicamentos, consultas, procedimentos internações, exames laboratoriais e de imagem, reposição de hemocomponentes e nutrição recebida. A quantidade total de cada recurso e componente utilizado foi obtida e multiplicada pelo seu valor unitário e, desta maneira, o custo individual de cada paciente foi obtido. RESULTADOS: O total gasto pelos 482 pacientes foi de US$ 6.064.986,51. Os custos ambulatoriais corresponderam a 32,4% do total (US$ 1.965.045,52) e os custos em internação corresponderam a 67,6% do total (US$ 4.099.940,99). Os principais determinantes do custo em ambulatório foram: medicamentos (44,31%) e exames laboratoriais e de imagem (31,68%). Os principais determinantes de custo em internações foram: medicamentos (35,20%), utilização do leito em enfermaria e em UTI (26,38%) e exames laboratoriais (13,72%) Pacientes com valores de MELD entre 25-30 foram os de maiores custos em lista de espera (US$ 16.686,74 ± 16,105.02) e os de menor custo foram os pacientes com MELD abaixo de 17 (US$ 5.703,22 ± 9.318,68). CONCLUSÃO: O custo total em lista de espera para o transplante hepático aumenta de acordo com a gravidade do paciente. Individualmente, internações, reposição de hemocomponentes e o tratamento do paciente com carcinoma hepatocelular são os principais determinantes de custo para os pacientes em lista de espera para o transplante hepático. Quanto maior o tempo de espera, maiores serão os custos em lista, causando maior impacto nos sistemas de saúde.

ABSTRACT BACKGROUND: The pre-transplant period is complex and includes lots of procedures. The severity of liver disease predisposes to a high number of hospitalizations and high costs procedures. Economic evaluation studies are important tools to handle costs on the waiting list for liver transplantation. OBJECTIVE: The objective of the present study was to evaluate the total cost of the patient on the waiting list for liver transplantation and the main resources related to higher costs. METHODS: A cost study in a cohort of 482 patients registered on waiting list for liver transplantation was carried out. In 24 months follow-up, we evaluated all costs of materials, medicines, consultations, procedures, hospital admissions, laboratorial tests and image exams, hemocomponents replacements, and nutrition. The total amount of each resource or component used was aggregated and multiplied by the unitary cost, and thus individual cost for each patient was obtained. RESULTS: The total expenditure of the 482 patients was US$ 6,064,986.51. Outpatient and impatient costs correspond to 32.4% of total cost (US$ 1,965,045.52) and 67.6% (US$ 4,099,940.99) respectively. Main cost drivers in outpatient were: medicines (44.31%), laboratorial tests and image exams (31.68%). Main cost drivers regarding hospitalizations were: medicines (35.20%), bed use in ward and ICU (26.38%) and laboratorial tests (13.72%). Patients with MELD score between 25-30 were the most expensive on the waiting list (US$ 16,686.74 ± 16,105.02) and the less expensive were those with MELD below 17 (US$ 5,703.22 ± 9,318.68). CONCLUSION: Total costs on the waiting list for liver transplantation increased according to the patient’s severity. Individually, hospitalizations, hemocomponents reposition and hepatocellular carcinoma treatment were the main cost drivers to the patient on the waiting list. The longer the waiting time, the higher the total cost on list, causing greater impact on health systems.

https://doi.org/10.1590/s0004-2803.201700000-35 1169 downloads

The Lowest Prevalence of Cholelithiasis in the Americas - An Autopsy-based Study
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Asperti, André Marangoni

; Reis, Paulo

; Diniz, Marcio Augusto

; Pinto, Mariana Dourado

; Silva Júnior, Edinésio Carlos da

; Silva, Danilo Felipe Dias da

; D’Albuquerque, Luiz Augusto Carneiro

; Andraus, Wellington

Clinics

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Jul 2016, Volume 71 Nº 7 Páginas 365 - 369

Resumo: En | Texto: En | PDF: En

OBJECTIVES: This study used autopsy to evaluate the prevalence of cholelithiasis and its associated risk factors in a population of healthy, young subjects who suffered a violent or natural death. METHODS: This study is a prospective evaluation of autopsies of 446 individuals from 2011 to 2013 in Brazil. Of that sample, 330 (74%) subjects died from violent deaths and 116 (26%) died naturally. The presence of biliary calculi, previous cholecystectomy, gender, age, ethnicity, body mass index (BMI) and alcohol use were evaluated. RESULTS: In the natural death group, 6.9% (95% CI 3.39 to 13.28) (3.08% of the male subjects and 11.76% of the female subjects) exhibited evidence of gallbladder disease. In the violent death group, only 2.12% (95% CI 0.96 to 4.43) (2.17% of the male subjects and 1.85% of the female subjects) of the subjects exhibited evidence of gallbladder disease. Age was correlated with the prevalence of gallbladder disease, but BMI was correlated with only gallbladder disease in the natural death group. CONCLUSIONS: This population has the lowest prevalence of cholelithiasis in the Americas. Dietary habits, physical activity, ethnicity, alcohol consumption and genetic factors may be responsible for this low prevalence.

https://doi.org/10.6061/clinics/2016(07)02 1107 downloads

Mechanisms of the beneficial effect of sevoflurane in liver ischemia/reperfusion injury
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Cavalcante, Fernanda Paula

; Coelho, Ana Maria Mendonça

; Machado, Marcel Cerqueira Cesar

; Sampietre, Sandra Nassa

; Patzina, Rosely Antunes

; Diniz, Márcio Augusto

; Chaib, Eleazar

; D'Albuquerque, Luiz Augusto Carneiro

Acta Cirúrgica Brasileira

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Nov 2015, Volume 30 Nº 11 Páginas 749 - 755

Resumo: En | Texto: En | PDF: En

PURPOSE: To evaluate the underlying mechanisms by which sevoflurane protects the liver against ischemia/reperfusion injury evaluate the mechanism by which sevoflurane exerts this protective effect. METHODS: Twenty-six rats were subjected to partial ischemia/reperfusion injury for 1h: one group received no treatment, one group received sevoflurane, and sham group of animals received laparotomy only. Four hours after reperfusion, levels of alanine and aspartate aminotransferases, tumor necrosis factor-a, and interleukins 6 and 10 were measured. Analyses of mitochondrial oxidation and phosphorylation, malondialdehyde content, histology, and pulmonary vascular permeability were performed. RESULTS: Serum levels of alanine and aspartate aminotransferases were significantly lower in the sevoflurane group compared to untreated controls (p<0.05). The sevoflurane group also showed preservation of liver mitochondrial function compared to untreated controls (p<0.05). Sevoflurane administration did not alter increases in serum levels of tumor necrosis factor-a, and interleukins 6 and 10. Sevoflurane treatment significantly reduced the coagulative necrosis induced by ischemia/reperfusion (p<0.05). Pulmonary vascular permeability was preserved in the sevoflurane group compared to untreated controls. CONCLUSION: Sevoflurane administration protects the liver against ischemia/reperfusion injury, via preservation of mitochondrial function, and also preserves lung vascular permeability.

https://doi.org/10.1590/S0102-865020150110000005 1791 downloads

Clinical and pathological evaluation of fibrolamellar hepatocellular carcinoma: a single center study of 21 cases
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Chagas, Aline Lopes

; Kikuchi, Luciana

; Herman, Paulo

; Alencar, Regiane S.S.M.

; Tani, Claudia M.

; Diniz, Márcio Augusto

; Pugliese, Vincenzo

; Rocha, Manoel de Souza

; D′Albuquerque, Luiz Augusto Carneiro

; Carrilho, Flair Jose

; Alves, Venancio A.F.

Clinics

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Mar 2015, Volume 70 Nº 3 Páginas 207 - 213

Resumo: En | Texto: En | PDF: En

OBJECTIVES: Fibrolamellar hepatocellular carcinoma is a rare primary malignant liver tumor that differs from conventional hepatocellular carcinoma in several aspects. The aim of this study was to describe the clinical, surgical and histopathological features of fibrolamellar hepatocellular carcinoma and to analyze the factors associated with survival. METHODS: We identified 21 patients with histopathologically diagnosed fibrolamellar hepatocellular carcinoma over a 22-year period. Clinical information was collected from medical records and biopsies, and surgical specimens were reviewed. RESULTS: The median age at diagnosis was 20 years. Most patients were female (67%) and did not have associated chronic liver disease. Most patients had a single nodule, and the median tumor size was 120 mm. Vascular invasion was present in 31% of patients, and extra-hepatic metastases were present in 53%. Fourteen patients underwent surgery as the first-line therapy, three received chemotherapy, and four received palliative care. Eighteen patients had “pure fibrolamellar hepatocellular carcinoma,” whereas three had a distinct area of conventional hepatocellular carcinoma and were classified as having “mixed fibrolamellar hepatocellular carcinoma.” The median overall survival was 36 months. The presence of “mixed fibrolamellar hepatocellular carcinoma” and macrovascular invasion were predictors of poor survival. Vascular invasion was associated with an increased risk of recurrence in patients who underwent surgery. CONCLUSION: Fibrolamellar hepatocellular carcinoma was more common in young female patients without chronic liver disease. Surgery was the first therapeutic option to achieve disease control, even in advanced cases. Vascular invasion was a risk factor for tumor recurrence. The presence of macrovascular invasion and areas of conventional hepatocellular carcinoma were directly related to poor survival.

https://doi.org/10.6061/clinics/2015(03)10 2146 downloads

10.

QUALIS PERIODIC EVALUATION: ANALYSIS OF QUALIS UPGRADE IN MEDICINE III
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Jukemura, José

; Diniz, Márcio Augusto

Revista do Colégio Brasileiro de Cirurgiões

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2015, Volume 42 Supl. 1 Páginas 54 - 56

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Objetivo: Avaliar os resultados preliminares sobre a Medicina III do up-grade oportunizado pela Capes para todas as áreas. Métodos: Foram utilizados os documentos de áreas e os relevantes ao tema disponíveis online no site da Capes entre 2009 e 2013. Procurou-se focar a pesquisa em dois aspectos para responder duas perguntas: 1) a estratificação do Qualis é semelhante nas três áreas da medicina? e 2) a evolução do Qualis da Medicina III foi maior? Resultados: A Medicina III apresentou evolução em sua classificação Qualis e está publicando em revistas com maior fator de impacto e é praticamente igual ao da Medicina I e II. Conclusão: A área foi a que apresentou maior evolução nestes últimos triênios

Objective: To evaluate the preliminary results related to journals up-grade that was used by Medicine III, through opportunity offered by Capes to all agency areas programs. Methods: Were used area document of Medicine I, II and III, besides other relevant topics available online at Capes site, between 2009 and 2013. The research was focused to answer two questions: 1) the stratification of Qualis is similar in the three areas of medicine? and 2) the evolution of Qualis in Medicine III was higher? Results: Medicine III showed an increase in its Qualis classification and is publishing in journals with higher impact factors, virtually the same as the Medicine I and II. Conclusion: The area showed the strongest growth in recent three-year periods.

https://doi.org/10.1590/0100-69912015S01020 1427 downloads

11.

II Diretriz de Ressonância Magnética e Tomografia Computadorizada Cardiovascular da Sociedade Brasileira de Cardiologia e do Colégio Brasileiro de Radiologia
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Sara, Leonardo

; Szarf, Gilberto

; Tachibana, Adriano

; Shiozaki, Afonso Akio

; Villa, Alexandre Volney

; Oliveira, Amarino Carvalho de

; Albuquerque, Andrei Skromov de

; Rochitte, Carlos Eduardo

; Nomura, César Higa

; Azevedo, Clerio Francisco

; Jasinowodolinski, Dany

; Tassi, Eduardo Marinho

; Medeiros, Fabio de Morais

; Kay, Fernando Uliana

; Junqueira, Flávia Pegado

; Azevedo, Guilherme S. A.

; Monte, Guilherme Urpia

; Pinto, Ibraim Masciarelli Francisco

; Gottlieb, Ilan

; Andrade, Joalbo

; Lima, João A. C.

; Parga Filho, José Rodrigues

; Kelendjian, Juliana

; Fernandes, Juliano Lara

; Iquizli, Leonardo

; Correia, Luis C. L.

; Quaglia, Luiz Augusto

; Gonçalves, Luiz Flavio Galvão

; Ávila, Luiz Francisco

; Zapparoli, Marcello

; Hadlich, Marcelo

; Nacif, Marcelo Souto

; Barbosa, Márcia de Melo

; Minami, Márcio Hiroshi

; Bittencourt, Marcio Sommer

; Siqueira, Maria Helena Albernaz

; Silva, Marly Conceição

; Lopes, Marly Maria Uellendahl

; Marques, Mateus Diniz

; Vieira, Mônica La Rocca

; Coellho Filho, Otávio Rizzi

; Schvartzman, Paulo R.

; Santos, Raul D.

; Cury, Ricardo C.

; Loureiro, Ricardo

; Cury, Roberto Caldeira

; Sasdelli Neto, Roberto

; Macedo, Robson

; Cerci, Rodrigo Julio

; Faria Filho, Rui Alberto de

; Cardoso, Sávio

; Naves, Thiago

; Magalhães, Tiago Augusto

; Senra, Tiago

; Burgos, Ursula Maria Moreira Costa

; Moreira, Valéria de Melo

; Ishikawa, Walther Yoshiharu

Arquivos Brasileiros de Cardiologia

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Dez 2014, Volume 103 Nº 6 Páginas 1 - 86

Resumo: Pt | Texto: Pt | PDF: Pt

https://doi.org/10.5935/abc.2014S006 67586 downloads

12.

An analysis of tacrolimus-related complications in the first 30 days after liver transplantation
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Nacif, Lucas Souto

; David, André Ibrahim

; Pinheiro, Rafael Soares

; Diniz, Marcio Augusto

; Andraus, Wellington

; Cruz Junior, Ruy Jorge

; D′Albuquerque, Luiz A. Carneiro

Clinics

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Nov 2014, Volume 69 Nº 11 Páginas 745 - 749

Resumo: En | Texto: En | PDF: En

OBJECTIVES:Orthotopic liver transplantation has improved survival in patients with end-stage liver disease; however, therapeutic strategies that achieve ideal immunosuppression and avoid early complications are lacking. To correlate the dose and level of Tacrolimus with early complications, e.g., rejection, infection and renal impairment, after liver transplantation. From November 2011 to May 2013, 44 adult liver transplant recipients were studied in this retrospective comparative study.RESULTS:The most frequent indication for liver transplantation was hepatitis C cirrhosis (47.7%), with a higher prevalence observed in male patients (68.18%). The ages of the subjects ranged from 19-71 and the median age was 55.5 years. The mean length of the hospital stay was 16.1±9.32 days and the mean Model for End-stage Liver Disease score was 26.18±4.28. There were five cases of acute cellular rejection (11.37%) and 16 cases of infection (36.37%). The blood samples that were collected and analyzed over time showed a significant correlation between the Tacrolimus blood level and the deterioration of glomerular filtration rate and serum creatinine (p<0.05). Patients with infections had a higher serum level of Tacrolimus (p= 0.012). The dose and presence of rejection were significantly different (p= 0.048) and the mean glomerular filtration rate was impaired in patients who underwent rejection compared with patients who did not undergo rejection (p= 0.0084).CONCLUSION:Blood Tacrolimus levels greater than 10 ng/ml were correlated with impaired renal function. Doses greater than 0.15 mg/kg/day were associated with the prevention of acute cellular rejection but predisposed patients to infectious disease.

https://doi.org/10.6061/clinics/2014(11)07 2067 downloads

13.

Environmental influences on antibody-enhanced dengue disease outcomes
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Diniz, Daniel Guerreiro

; Fôro, César Augusto Raiol

; Turiel, Maíra C Pereira

; Sosthenes, Marcia CK

; Demachki, Sâmia

; Gomes, Giovanni Freitas

; Rego, Carla M Damasceno

; Magalhães, Marina Cutrim

; Pinho, Brunno Gomes

; Ramos, Juliana Pastana

; Casseb, Samir M Moraes

; Brito, Maysa de Vasconcelos

; Silva, Eliana Vieira Pinto da

; Nunes, Marcio Roberto Teixeira

; Diniz, José Antonio Picanço

; Cunningham, Colm

; Perry, Victor Hugh

; Vasconcelos, Pedro F Costa

; Diniz, Cristovam W Picanço

Memórias do Instituto Oswaldo Cruz

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Dez 2012, Volume 107 Nº 8 Páginas 1021 - 1029

Resumo: En | Texto: En | PDF: En

Because an enriched environment (EE) enhances T-cell activity and T-lymphocytes contribute to immunopathogenesis during heterologous dengue virus (DENV) infections, we hypothesised that an EE increases dengue severity. To compare single serotype (SS) and antibody-enhanced disease (AED) infections regimens, serial intraperitoneal were performed with DENV3 (genotype III) infected brain homogenate or anti-DENV2 hyperimmune serum followed 24 h later by DENV3 (genotype III) infected brain homogenate. Compared AED for which significant differences were detected between the EE and impoverished environmental (IE) groups (Kaplan-Meyer log-rank test, p = 0.0025), no significant differences were detected between the SS experimental groups (Kaplan-Meyer log-rank test, p = 0.089). Survival curves from EE and IE animals infected with the AED regimen were extended after corticoid injection and this effect was greater in the EE than in the IE group (Kaplan-Meyer log-rank test, p = 0.0162). Under the AED regimen the EE group showed more intense clinical signs than the IE group. Dyspnoea, tremor, hunched posture, ruffled fur, immobility, pre-terminal paralysis, shock and death were associated with dominant T-lymphocytic hyperplasia and presence of viral antigens in the liver and lungs. We propose that the increased expansion of these memory T-cells and serotype cross-reactive antibodies facilitates the infection of these cells by DENV and that these events correlate with disease severity in an EE.

3419 downloads

14.

Latex constituents from Calotropis procera (R. Br.) display toxicity upon egg hatching and larvae of Aedes aegypti (Linn.)
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Ramos, Márcio Viana

; Bandeira, Glaís de Paiva

; Freitas, Cléverson Diniz Teixeira de

; Nogueira, Nádia Accioly Pinto

; Alencar, Nylane Maria Nunes

; Sousa, Petrônio Augusto Simão de

; Carvalho, Ana Fontenele Urano

Memórias do Instituto Oswaldo Cruz

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Ago 2006, Volume 101 Nº 5 Páginas 503 - 510

Resumo: En | Texto: En | PDF: En

Calotropis procera R. Br. (Asclepiadaceae) is a well-known medicinal plant with leaves, roots, and bark being exploited by popular medicine to fight many human and animal diseases. This work deals with the fractionation of the crude latex produced by the green parts of the plant and aims to evaluate its toxic effects upon egg hatching and larval development of Aedes aegypti. The whole latex was shown to cause 100% mortality of 3rd instars within 5 min. It was fractionated into water-soluble dialyzable (DF) and non-dialyzable (NDF) rubber-free materials. Both fractions were partially effective to prevent egg hatching and most of individuals growing under experimental conditions died before reaching 2nd instars or stayed in 1st instars. Besides, the fractions were very toxic to 3rd instars causing 100% mortality within 24 h. When both fractions were submitted to heat-treatment the toxic effects were diminished considerably suggesting low thermostability of the toxic compounds. Polyacrylamide gel electrophoresis of both fractions and their newly fractionated peaks obtained through ion exchange chromatography or desalting attested the presence of proteins in both materials. When submitted to protease digestion prior to larvicidal assays NDF lost most of its toxicity but DF was still strongly active. It may be possible that the highly toxic effects of the whole latex from C. procera upon egg hatching and larvae development should be at least in part due to its protein content found in NDF. However the toxicity seems also to involve non protein molecules present in DF.

37687 downloads Citado 3 vezes em SciELO

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